Advertisement
Journal of Clinical Oncology  
Search for:
Limit by:
  Browse by Subject or Issue
Home Search or Browse JCO My JCO Subscriptions Customer Service Site Map

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Save to my personal folders
Right arrow Download to citation manager
Right arrowRights & Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Flamen, P.
Right arrow Articles by Mortelmans, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Flamen, P.
Right arrow Articles by Mortelmans, L.
Journal of Clinical Oncology, Vol 18, Issue 18 (September), 2000: 3202-3210
© 2000 American Society for Clinical Oncology

Utility of Positron Emission Tomography for the Staging of Patients With Potentially Operable Esophageal Carcinoma

By P. Flamen, A. Lerut, E. Van Cutsem, W. De Wever, M. Peeters, S. Stroobants, P. Dupont, G. Bormans, M. Hiele, P. De Leyn, D. Van Raemdonck, W. Coosemans, N. Ectors, K. Haustermans, L. Mortelmans

From the Departments of Nuclear Medicine, Internal Medicine, Radiology, Radiation Oncology, Pathology, and Thoracic Surgery, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.

Address reprint requests to Patrick Flamen, MD, Department of Nuclear Medicine, University Hospital Gasthuisberg, Herestraat 49, 3000 Leuven, Belgium; email Patrick.Flamen{at}uz.kuleuven.ac.be

PURPOSE: A prospective study of preoperative tumor-node-metastasis staging of patients with esophageal cancer (EC) was designed to compare the accuracy of 18-F-fluoro-deoxy-D-glucose (FDG) positron emission tomography (PET) with conventional noninvasive modalities.

PATIENTS AND METHODS: Seventy-four patients with carcinomas of the esophagus (n = 43) or gastroesophageal junction (n = 31) were studied. All patients underwent attenuation-corrected FDG-PET imaging, a spiral computed tomography (CT) scan, and an endoscopic ultrasound (EUS).

RESULTS: FDG-PET demonstrated increased activity in the primary tumor in 70 of 74 patients (sensitivity: 95%). False-negative PET images were found in four patients with T1 lesions. Thirty-four patients (46%) had stage IV disease. FDG-PET had a higher accuracy for diagnosing stage IV disease compared with the combination of CT and EUS (82% v 64%, respectively; P = .004). FDG-PET had additional diagnostic value in 16 (22%) of 74 patients by upstaging 11 (15%) and downstaging five (7%) patients. Thirty-nine (53%) of the 74 patients underwent a 2- or 3-field lymphadenectomy in conjunction with primary curative esophagectomy. In these patients, tumoral involvement was found in 21 local and 35 regional or distant lymph nodes (LN). For local LN, the sensitivity of FDG-PET was lower than EUS (33% v 81%, respectively; P = .027), but the specificity may have been higher (89% v 67%, respectively; P = not significant [NS]). For the assessment of regional and distant LN involvement, compared with the combined use of CT and EUS, FDG-PET had a higher specificity (90% v 98%, respectively; P = .025) and a similar sensitivity (46% v 43%, respectively; P = NS).

CONCLUSION: PET significantly improves the detection of stage IV disease in EC compared with the conventional staging modalities. PET improves diagnostic specificity for LN staging.




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
R. G. Berrisford, W.-L. Wong, D. Day, E. Toy, M. Napier, K. Mitchell, and S. Wajed
The decision to operate: role of integrated computed tomography positron emission tomography in staging oesophageal and oesophagogastric junction cancer by the multidisciplinary team
Eur. J. Cardiothorac. Surg., June 1, 2008; 33(6): 1112 - 1116.
[Abstract] [Full Text] [PDF]

Home page
 RadioGraphicsHome page
J. F. Bruzzi, R. F. Munden, M. T. Truong, E. M. Marom, B. S. Sabloff, G. W. Gladish, R. B. Iyer, T.-S. Pan, H. A. Macapinlac, and J. J. Erasmus
PET/CT of Esophageal Cancer: Its Role in Clinical Management
RadioGraphics, November 1, 2007; 27(6): 1635 - 1652.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
O. N. Kozyreva, D. A. Mezentsev, D. R. King, C. R. Gomez-Fernandez, B. Ardalan, and A. S. Livingstone
Asymptomatic Muscle Metastases From Esophageal Adenocarcinoma
J. Clin. Oncol., August 20, 2007; 25(24): 3780 - 3783.
[Full Text] [PDF]

Home page
 Jpn J Clin OncolHome page
Y. Murakami, M. Kenjo, T. Uno, M. Oguchi, M. Shimada, T. Teshima, and the Japanese Patterns of Care Study Working Subgro
Results of the 1999 2001 Japanese Patterns of Care Study for Patients Receiving Definitive Radiation Therapy without Surgery for Esophageal Cancer
Jpn. J. Clin. Oncol., July 23, 2007; (2007) hym055v1.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
S. G. Little, T. W. Rice, B. Bybel, D. P. Mason, S. C. Murthy, G. W. Falk, L. A. Rybicki, and E. H. Blackstone
Is FDG-PET indicated for superficial esophageal cancer?
Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 791 - 796.
[Abstract] [Full Text] [PDF]

Home page
 JNMHome page
C. C. Riedl, T. Akhurst, S. Larson, S. F. Stanziale, S. Tuorto, A. Bhargava, H. Hricak, D. Klimstra, and Y. Fong
18F-FDG PET Scanning Correlates with Tissue Markers of Poor Prognosis and Predicts Mortality for Patients After Liver Resection for Colorectal Metastases
J. Nucl. Med., May 1, 2007; 48(5): 771 - 775.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
J. Y. Choi, K.-T. Jang, Y. M. Shim, K. Kim, G. Ahn, K.-H. Lee, Y. Choi, Y. S. Choe, and B.-T. Kim
Prognostic Significance of Vascular Endothelial Growth Factor Expression and Microvessel Density in Esophageal Squamous Cell Carcinoma: Comparison With Positron Emission Tomography
Ann. Surg. Oncol., August 1, 2006; 13(8): 1054 - 1062.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
J. Barentsz, S. Takahashi, W. Oyen, R. Mus, P. De Mulder, R. Reznek, M. Oudkerk, and W. Mali
Commonly Used Imaging Techniques for Diagnosis and Staging
J. Clin. Oncol., July 10, 2006; 24(20): 3234 - 3244.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. Rizk, R. J. Downey, T. Akhurst, M. Gonen, M. S. Bains, S. Larson, and V. Rusch
Preoperative (18)[F]-Fluorodeoxyglucose Positron Emission Tomography Standardized Uptake Values Predict Survival After Esophageal Adenocarcinoma Resection.
Ann. Thorac. Surg., March 1, 2006; 81(3): 1076 - 1081.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
S. R. DeMeester
Adenocarcinoma of the Esophagus and Cardia: A Review of the Disease and Its Treatment
Ann. Surg. Oncol., January 1, 2006; 13(1): 12 - 30.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
H. L. van Westreenen, J. T. M. Plukker, D. C. P. Cobben, C. J. M. Verhoogt, H. Groen, and P. L. Jager
Prognostic Value of the Standardized Uptake Value in Esophageal Cancer
Am. J. Roentgenol., August 1, 2005; 185(2): 436 - 440.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
C. J. Lightdale and K. G. Kulkarni
Role of Endoscopic Ultrasonography in the Staging and Follow-Up of Esophageal Cancer
J. Clin. Oncol., July 10, 2005; 23(20): 4483 - 4489.
[Abstract] [Full Text] [PDF]

Home page
 Jpn J Clin OncolHome page
M. Tahara, A. Ohtsu, S. Hironaka, N. Boku, S. Ishikura, Y. Miyata, T. Ogino, and S. Yoshida
Clinical Impact of Criteria for Complete Response (CR) of Primary Site to Treatment of Esophageal Cancer
Jpn. J. Clin. Oncol., June 1, 2005; 35(6): 316 - 323.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Cancer Res.Home page
G. J. Kelloff, J. M. Hoffman, B. Johnson, H. I. Scher, B. A. Siegel, E. Y. Cheng, B. D. Cheson, J. O'Shaughnessy, K. Z. Guyton, D. A. Mankoff, et al.
Progress and Promise of FDG-PET Imaging for Cancer Patient Management and Oncologic Drug Development
Clin. Cancer Res., April 15, 2005; 11(8): 2785 - 2808.
[Abstract] [Full Text] [PDF]

Home page
 JNMHome page
H. L. van Westreenen, D. C.P. Cobben, P. L. Jager, H. M. van Dullemen, J. Wesseling, P. H. Elsinga, and J. Th. Plukker
Comparison of 18F-FLT PET and 18F-FDG PET in Esophageal Cancer
J. Nucl. Med., March 1, 2005; 46(3): 400 - 404.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
M. J. Gollub, R. Lefkowitz, C. S. Moskowitz, D. Ilson, D. Kelsen, and H. Felderman
Pelvic CT in Patients with Esophageal Cancer
Am. J. Roentgenol., February 1, 2005; 184(2): 487 - 490.
[Abstract] [Full Text] [PDF]

Home page
 JNMHome page
J. Y. Choi, H.-J. Jang, Y. M. Shim, K. Kim, K. S. Lee, K.-H. Lee, Y. Choi, Y. S. Choe, and B.-T. Kim
18F-FDG PET in Patients with Esophageal Squamous Cell Carcinoma Undergoing Curative Surgery: Prognostic Implications
J. Nucl. Med., November 1, 2004; 45(11): 1843 - 1850.
[Abstract] [Full Text] [PDF]

Home page
 Arch SurgHome page
W. Kneist, M. Schreckenberger, P. Bartenstein, C. Menzel, K. Oberholzer, and T. Junginger
Prospective Evaluation of Positron Emission Tomography in the Preoperative Staging of Esophageal Carcinoma
Arch Surg, October 1, 2004; 139(10): 1043 - 1049.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Cancer Res.Home page
M. C. A. van Kouwen, J. P. H. Drenth, W. J. G. Oyen, J. H. F. M. de Bruin, M. J. Ligtenberg, J. J. (H. Bonenkamp, J. H. J. M. van Krieken, and F. M. Nagengast
[18F]Fluoro-2-deoxy-D-glucose Positron Emission Tomography Detects Gastric Carcinoma in an Early Stage in an Asymptomatic E-Cadherin Mutation Carrier
Clin. Cancer Res., October 1, 2004; 10(19): 6456 - 6459.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
H.L. van Westreenen, M. Westerterp, P.M.M. Bossuyt, J. Pruim, G.W. Sloof, J.J.B. van Lanschot, H. Groen, and J.Th.M. Plukker
Systematic Review of the Staging Performance of 18F-Fluorodeoxyglucose Positron Emission Tomography in Esophageal Cancer
J. Clin. Oncol., September 15, 2004; 22(18): 3805 - 3812.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
R. Iyer, N. Wilkinson, T. Demmy, and M. Javle
Controversies in the Multimodality Management of Locally Advanced Esophageal Cancer: Evidence-Based Review of Surgery Alone and Combined-Modality Therapy
Ann. Surg. Oncol., July 1, 2004; 11(7): 665 - 673.
[Abstract] [Full Text] [PDF]

Home page
 JNMHome page
P. A.M. Heeren, P. L. Jager, F. Bongaerts, H. van Dullemen, W. Sluiter, and J. Th.M. Plukker
Detection of Distant Metastases in Esophageal Cancer with 18F-FDG PET
J. Nucl. Med., June 1, 2004; 45(6): 980 - 987.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
M. Koshy, N. Esiashvilli, J. C. Landry, C. R. Thomas Jr., and R. H. Matthews
Multiple Management Modalities in Esophageal Cancer: Epidemiology, Presentation and Progression, Work-up, and Surgical Approaches
Oncologist, April 1, 2004; 9(2): 137 - 146.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
H. A. Wieder, B. L.D.M. Brucher, F. Zimmermann, K. Becker, F. Lordick, A. Beer, M. Schwaiger, U. Fink, J. R. Siewert, H. J. Stein, et al.
Time Course of Tumor Metabolic Activity During Chemoradiotherapy of Esophageal Squamous Cell Carcinoma and Response to Treatment
J. Clin. Oncol., March 1, 2004; 22(5): 900 - 908.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
P. C. Enzinger and R. J. Mayer
Esophageal Cancer
N. Engl. J. Med., December 4, 2003; 349(23): 2241 - 2252.
[Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
H. L. van Westreenen, P. A.M. Heeren, P. L. Jager, H. M. van Dullemen, H. Groen, and J. Th.M. Plukker
Pitfalls of Positive Findings in Staging Esophageal Cancer With F-18-Fluorodeoxyglucose Positron Emission Tomography
Ann. Surg. Oncol., November 1, 2003; 10(9): 1100 - 1105.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
J. V. Rasanen, E. I. T. Sihvo, M. J. Knuuti, H. R. I. Minn, M. E. S. Luostarinen, P. Laippala, T. Viljanen, and J. A. Salo
Prospective Analysis of Accuracy of Positron Emission Tomography, Computed Tomography, and Endoscopic Ultrasonography in Staging of Adenocarcinoma of the Esophagus and the Esophagogastric Junction
Ann. Surg. Oncol., October 1, 2003; 10(8): 954 - 960.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
Y. C. Yoon, K. S. Lee, Y. M. Shim, B.-T. Kim, K. Kim, and T. S. Kim
Metastasis to Regional Lymph Nodes in Patients with Esophageal Squamous Cell Carcinoma: CT versus FDG PET for Presurgical Detection— Prospective Study
Radiology, June 1, 2003; 227(3): 764 - 770.
[Abstract] [Full Text] [PDF]

Home page
 GutHome page
B B Chin and R L Wahl
18F-Fluoro-2-deoxyglucose positron emission tomography in the evaluation of gastrointestinal malignancies
Gut, June 1, 2003; 52(90004): iv23 - 29.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
R. J. Downey, T. Akhurst, D. Ilson, R. Ginsberg, M. S. Bains, M. Gonen, H. Koong, M. Gollub, B. D. Minsky, M. Zakowski, et al.
Whole Body 18FDG-PET and the Response of Esophageal Cancer to Induction Therapy: Results of a Prospective Trial
J. Clin. Oncol., February 1, 2003; 21(3): 428 - 432.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
D. K. Dhar, M. Tachibana, N. Kinukawa, M. Riruke, H. Kohno, A. G. Little, and N. Nagasue
The Prognostic Significance of Lymph Node Size in Patients With Squamous Esophageal Cancer
Ann. Surg. Oncol., December 1, 2002; 9(10): 1010 - 1016.
[Abstract] [Full Text] [PDF]

Home page
 JNMHome page
B. G.M. Durie, A. D. Waxman, A. D'Agnolo, and C. M. Williams
Whole-Body 18F-FDG PET Identifies High-Risk Myeloma
J. Nucl. Med., November 1, 2002; 43(11): 1457 - 1463.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. B. Wallace, P. J. Nietert, C. Earle, M. J. Krasna, R. H. Hawes, B. J. Hoffman, and C. E. Reed
An analysis of multiple staging management strategies for carcinoma of the esophagus: computed tomography, endoscopic ultrasound, positron emission tomography, and thoracoscopy/laparoscopy
Ann. Thorac. Surg., October 1, 2002; 74(4): 1026 - 1032.
[Abstract] [Full Text] [PDF]

Home page
 Arch SurgHome page
S. M. Wren, P. Stijns, and S. Srinivas
Positron Emission Tomography in the Initial Staging of Esophageal Cancer
Arch Surg, September 1, 2002; 137(9): 1001 - 1006.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. A. D'Amico, T. Z. Wong, D. H. Harpole, S. D. Brown, and R. E. Coleman
Impact of computed tomography-positron emission tomography fusion in staging patients with thoracic malignancies
Ann. Thorac. Surg., July 1, 2002; 74(1): 160 - 163.
[Abstract] [Full Text] [PDF]

Home page
 Jpn J Clin OncolHome page
Y. Tachimori
Cancer Screening in Patients with Cancer
Jpn. J. Clin. Oncol., April 1, 2002; 32(4): 118 - 119.
[Full Text] [PDF]

Home page
 Ann OncolHome page
P. Flamen, E. Van Cutsem, A. Lerut, J.-P. Cambier, K. Haustermans, G. Bormans, P. De Leyn, D. Van Raemdonck, W. De Wever, N. Ectors, et al.
Positron emission tomography for assessment of the response to induction radiochemotherapy in locally advanced oesophageal cancer
Ann. Onc., March 1, 2002; 13(3): 361 - 368.
[Abstract] [Full Text] [PDF]

Home page
 ImagingHome page
S F Barrington
Whole body applications of positron emission tomography in oncology
Imaging, September 1, 2001; 13(3): 185 - 196.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
W. A. Weber, K. Ott, K. Becker, H.-J. Dittler, H. Helmberger, N. E. Avril, G. Meisetschlager, R. Busch, J.-R. Siewert, M. Schwaiger, et al.
Prediction of Response to Preoperative Chemotherapy in Adenocarcinomas of the Esophagogastric Junction by Metabolic Imaging
J. Clin. Oncol., June 15, 2001; 19(12): 3058 - 3065.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
D. Kelsen
Preoperative Chemoradiotherapy for Esophageal Cancer
J. Clin. Oncol., January 15, 2001; 19(2): 283 - 285.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
P. Flamen, A. Lerut, E. Van Cutsem, J. P. Cambier, A. Maes, W. De Wever, M. Peeters, P. De Leyn, D. Van Raemdonck, and L. Mortelmans
The utility of positron emission tomography for the diagnosis and staging of recurrent esophageal cancer
J. Thorac. Cardiovasc. Surg., December 1, 2000; 120(6): 1085 - 1092.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
C. J. Lightdale
Positron Emission Tomography: Another Useful Test for Staging Esophageal Cancer
J. Clin. Oncol., September 18, 2000; 18(18): 3199 - 3201.
[Full Text] [PDF]


About
JCO		 Editorial
Roster		 Advertising
Information		 Librarians &
Institutions		 Rights &
Permissions		 PDA Services

Copyright © 2000 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
Terms and Conditions of Use
  HighWire Press HighWire Press™ assists in the publication of JCO Online