Esophageal cancer: PET/CT surveillance useful even in absence of clinical suspicion

  • Kim SJ & al.
  • Eur J Nucl Med Mol Imaging
  • 20 Jun 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) reliably detects esophageal carcinoma recurrence even in the absence of clinical indications.

Why this matters

  • About half of esophageal cancers recur within 2 years after surgery with curative intent.
  • FDG PET/CT has been shown to be useful in studies in which recurrence was suspected.

Study design

  • Retrospective analysis of 782 FDG PET/CT scans from 375 patients at a single institution.
  • A PET/CT scan was determined to be negative if recurrence was not diagnosed within 6 months.
  • Funding: Ministry of Health & Welfare, Korea.

Key results

  • FDG PET/CT scan had a sensitivity of 100% and a specificity of 94.0%.
  • The positive predictive value was 59.8%, with a positive likelihood ratio of 16.7.
  • The negative predictive value was 100%, and the negative likelihood ratio was 0.
  • When researchers conducted analyses by cancer stage, there was no significant difference of the sensitivity, specificity, or accuracy of FDG PET/CT between groups.
  • FDG PET/CT had a higher PPV for stage II or stage III cancers than for stage I (67.1% vs 39.3%; P=.010).

Limitations

  • Retrospective, single-institution Korean population.