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ORIGINAL ARTICLE
Year : 2012  |  Volume : 8  |  Issue : 4  |  Page : 619-625

Positron emission tomography/computed tomography and esophageal cancer in the clinical practice: How does it affect the prognosis?


1 Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto (IOV - IRCCS), Padova, Italy
2 Endoscopic Surgery Unit, Istituto Oncologico Veneto (IOV - IRCCS), Padova, Italy
3 Oncology Unit, Istituto Oncologico Veneto (IOV - IRCCS), Padova, Italy
4 Oncology Radiology Unit, Istituto Oncologico Veneto (IOV - IRCCS), Padova, Italy

Correspondence Address:
Anna R Cervino
Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto (IOV - IRCCS), Via Gattamelata, 64 35128, Padova
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.106580

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Aims: The aim of this study was to assess the diagnostic value of positron emission tomography/computed tomography (PET/CT) in staging of esophageal cancer and to evaluate the prognostic role of metabolic parameters before and after neo-adjuvant treatment. Settings and Design: Mono-institutional retrospective study. Materials and Methods: We retrospectively evaluated 29 patients who underwent PET/CT at initial staging and after neo-adjuvant therapy. Metabolic parameters were calculated: mean, average, maximum standardized uptake value (SUVmax), and total lesion glycolysis (TLG). Diagnostic advantages of PET/CT over conventional imaging (CI) were determined. The relationships between baseline and after-therapy SUVmax and TLG, change in SUV and TLG (reported as ∆) for the primary tumor and prognosis were assessed. Statistical Analysis Used: Non-parametric statistic (e.g. Wilcoxon test and chi-square test). Results: Twenty-nine patients were eligible for the initial staging. Thirteen patients were incorrectly staged based on CI; PET/CT was able to identify distant lymph nodes in seven patients (59%) and distant metastases in four (31%). The median SUVmax before and after neoadjuvant therapy was 10.38 and 3.53 (P = 0.0005), respectively. Only few semi-quantitative parameters obtained by PET/CT after neoadjuvant therapy seemed to have a prognostic value. TLG and ∆TLG were significantly different between disease-free and died patients (0.49 versus 15.51 and 100% versus 94%, respectively; all P = <0.05). Conclusions: PET/CT is confirmed as being able to detect distant metastases and to avoid unnecessary surgery. Although not routinely reported, post-neoadjuvant TLG and ∆TLG might be considered as useful prognostic parameters and should be further evaluated prospectively.


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