HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yoon, Y. C. Articles by Kim, T. S. Search for Related Content PubMed PubMed Citation Articles by Yoon, Y. C. Articles by Kim, T. S.

Metastasis to Regional Lymph Nodes in Patients with Esophageal Squamous Cell Carcinoma: CT versus FDG PET for Presurgical Detection— Prospective Study¹

¹ From the Departments of Radiology (Y.C.Y., K.S.L., T.S.K.), Thoracic Surgery (Y.M.S., K.K.), and Nuclear Medicine (B.T.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea. Received April 15, 2002; revision requested June 19; final revision received October 17; accepted November 5. Address correspondence to K.S.L. (e-mail: kslee@smc.samsung.co.kr).

PURPOSE: To prospectively compare the accuracy of fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and computed tomography (CT) for detection of primary tumor and metastasis to individual lymph node groups and for nodal staging.

MATERIALS AND METHODS: From February 2000 to July 2001, 81 patients with squamous cell carcinoma of the esophagus (78 men and three women; age range, 31–90 years; mean age, 63 years) underwent CT and FDG PET before esophagectomy and lymph node dissection. During surgery, all visible and palpable lymph nodes in the surgical fields were removed. The accuracies of CT and FDG PET for depiction of metastasis to lymph nodes were compared.

RESULTS: For depiction of malignant nodal groups in each lymph node group, the sensitivity, specificity, and accuracy, respectively, of CT were 11% (11 of 96 nodal groups), 95% (553 of 581), and 83% (564 of 677), whereas those of FDG PET were 30% (29 of 96), 90% (525 of 581), and 82% (554 of 677) (P values: <.001, .009, and .382, respectively). Twenty-eight false-positive interpretations were rendered at CT in evaluations of 11 mediastinal, four hilar, and 13 abdominal nodal groups, and 56 false-positive interpretations were rendered at FDG PET in evaluations of 23 mediastinal, 32 hilar, and one abdominal nodal group.

CONCLUSION: FDG PET is more sensitive than CT for depicting nodal metastases in patients with squamous cell carcinoma of the esophagus. FDG PET is slightly less specific than CT for depicting metastases, but the difference in specificity between the two modalities is statistically significant. Both FDG PET and CT have low sensitivity for depicting nodal metastasis. The relatively low specificity of FDG PET for depiction of nodal metastasis compared with that of CT is caused mainly by a high rate of false-positive hilar node interpretations.

© RSNA, 2003

Index terms: Esophagus, neoplasms, 71.321 • Lymphatic system, CT, 993.12912, 995.12912, 996.12912, 997.12912 • Neoplasms, metastases, 993.33, 995.33, 996.33, 997.33 • Positron emission tomography (PET) • Positron emission tomography (PET), comparative studies

This article has been cited by other articles:

				M. Karam, S. Roberts-Klein, N. Shet, J. Chang, and P. Feustel Bilateral Hilar Foci on 18F-FDG PET Scan in Patients Without Lung Cancer: Variables Associated with Benign and Malignant Etiology J. Nucl. Med., September 1, 2008; 49(9): 1429 - 1436. [Abstract] [Full Text] [PDF]

				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]

				P. Singh, B. Camazine, Y. Jadhav, R. Gupta, P. Mukhopadhyay, A. Khan, R. Reddy, Q. Zheng, D. D. Smith, R. Khode, et al. Endoscopic Ultrasound As a First Test for Diagnosis and Staging of Lung Cancer: A Prospective Study Am. J. Respir. Crit. Care Med., February 15, 2007; 175(4): 345 - 354. [Abstract] [Full Text] [PDF]

				S. Yuan, Y. Yu, K.S. C. Chao, Z. Fu, Y. Yin, T. Liu, S. Chen, X. Yang, G. Yang, H. Guo, et al. Additional Value of PET/CT over PET in Assessment of Locoregional Lymph Nodes in Thoracic Esophageal Squamous Cell Cancer J. Nucl. Med., August 1, 2006; 47(8): 1255 - 1259. [Abstract] [Full Text] [PDF]

				S. Umeoka, T. Koyama, K. Togashi, T. Saga, G. Watanabe, Y. Shimada, and M. Imamura Esophageal Cancer: Evaluation with Triple-Phase Dynamic CT--Initial Experience Radiology, June 1, 2006; 239(3): 777 - 783. [Abstract] [Full Text] [PDF]

				T. Hiraki, K. Yasui, H. Mimura, H. Gobara, T. Mukai, S. Hase, H. Fujiwara, N. Tajiri, Y. Naomoto, T. Yamatsuji, et al. Radiofrequency Ablation of Metastatic Mediastinal Lymph Nodes during Cooling and Temperature Monitoring of the Tracheal Mucosa to Prevent Thermal Tracheal Damage: Initial Experience Radiology, December 1, 2005; 237(3): 1068 - 1074. [Abstract] [Full Text] [PDF]

				M. Yun, J. S. Lim, S. H. Noh, W. J. Hyung, J. H. Cheong, J. K. Bong, A. Cho, and J. D. Lee Lymph Node Staging of Gastric Cancer Using 18F-FDG PET: A Comparison Study with CT J. Nucl. Med., October 1, 2005; 46(10): 1582 - 1588. [Abstract] [Full Text] [PDF]

				S. S. Shim, K. S. Lee, B.-T. Kim, M. J. Chung, E. J. Lee, J. Han, J. Y. Choi, O J. Kwon, Y. M. Shim, and S. Kim Non-Small Cell Lung Cancer: Prospective Comparison of Integrated FDG PET/CT and CT Alone for Preoperative Staging Radiology, September 1, 2005; 236(3): 1011 - 1019. [Abstract] [Full Text] [PDF]

				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]

				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]

				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]

				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]