Ann Thorac Surg 1999 Oct;68(4):1133-6; discussion 1136-7
Evaluation of distant metastases in esophageal cancer: 100 consecutive
positron emission tomography scans.
Luketich JD, Friedman DM, Weigel TL, Meehan MA, Keenan RJ, Townsend DW, Meltzer CC.
BACKGROUND: Pilot studies suggest positron emission tomography (PET) scanning may be
superior to conventional imaging in staging esophageal cancer, especially in the detection
of radiographically occult distant metastases. This report summarizes our experience with
PET in staging esophageal cancer. METHODS: One hundred consecutive PET scans in 91
patients with esophageal cancer referred for surgery were prospectively collected (1995 to
1998) and compared with computerized tomography (CT) and bone scan. PET images were
acquired after injection of 18F-fluorodeoxyglucose and evaluated for abnormal uptake.
Minimally invasive surgical staging (MIS) and/or clinical correlation were used to confirm
or refute imaging results. RESULTS: MIS or clinical correlation confirmed 70 distant
metastases in 39 cases. PET detected 51 metastases in 27 of 39 cases (69% sensitivity,
93.4% specificity, 84% accuracy) compared with CT, which detected 26 metastases in 18 of
39 cases (46.1% sensitivity, 73.8% specificity, 63% accuracy) (p < 0.01). CONCLUSIONS:
PET was more accurate than CT in detecting distant metastases, but was only 69% sensitive
compared with minimally invasive staging.
