The additional value of PET/CT over PET in FDG imaging of oesophageal cancer

Eur J Nucl Med Mol Imaging. 2005 Aug;32(8):918-24. doi: 10.1007/s00259-005-1795-y. Epub 2005 Apr 19.


Purpose: The aim of this study was to assess the value of combined PET/CT compared with PET reviewed side-by-side with CT, in patients with oesophageal cancer, before and after surgery.

Methods: Forty-one FDG PET/CT studies were performed in 32 patients with oesophageal cancer, before surgery (n = 18) or during follow-up after resection of the primary tumour (n = 23). One hundred and fifteen sites suspicious for malignancy were evaluated. PET/CT was prospectively compared with PET reviewed side-by-side with CT, for detection, accurate localisation and characterisation of malignant sites. PET/CT performance in different anatomical regions was compared before and after surgery. The impact of fused data on patient management was retrospectively assessed.

Results: PET/CT had an incremental value over PET for interpretation of 25 of 115 sites (22%), changing the initial characterisation of ten sites to either malignant (n = 1) or benign (n = 9), and defining the precise anatomical location of 15 sites. PET/CT provided better specificity and accuracy than PET for detecting sites of oesophageal cancer (81% and 90% vs 59% and 83% respectively, p < 0.01). Fusion was of special value for interpretation of cervical and abdomino-pelvic sites, for disease assessment in loco-regional lymph nodes before surgery and in regions of postoperative anatomical distortion. PET/CT had an impact on the further management of four patients (10%), by detecting nodal metastases that warranted disease upstaging (n = 2) and by excluding disease in sites of benign uptake after surgery (n = 2).

Conclusion: PET/CT improves the accuracy of FDG imaging in oesophageal cancer and provides data of diagnostic and therapeutic significance for further patient management.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Esophageal Neoplasms / diagnostic imaging*
  • Esophageal Neoplasms / surgery
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Image Enhancement / methods*
  • Male
  • Middle Aged
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Subtraction Technique
  • Tomography, X-Ray Computed / methods*


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18