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 Westerterp, M. Articles by Sloof, G. W. Search for Related Content PubMed PubMed Citation Articles by Westerterp, M. Articles by Sloof, G. W.

Esophageal Cancer: CT, Endoscopic US, and FDG PET for Assessment of Response to Neoadjuvant Therapy—Systematic Review¹

¹ From the Departments of Surgery (M.W., J.J.B.v.L.), Clinical Epidemiology and Biostatistics (J.B.R.), Radiology (J.S.), Gastroenterology (P.F.), and Nuclear Medicine (B.L.F.V.E., G.W.S.), Academic Medical Center, University of Amsterdam, Suite G4-130, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Surgery (H.L.v.W., J.T.M.P.) and Nuclear Medicine/PET Center (P.L.J.), University Hospital Groningen, Groningen, the Netherlands; and Department of Nuclear Medicine and PET Research, VU Medical Center, Amsterdam, the Netherlands (O.S.H.). Received June 11, 2004; revision requested August 24; revision received September 28; accepted October 22. Address correspondence to M.W. (e-mail: m.westerterp{at}AMC.UVA.NL).

PURPOSE: To compare diagnostic accuracy of computed tomography (CT), endoscopic ultrasonography (US), and fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) for assessment of response to neoadjuvant therapy in patients with esophageal cancer by using a systematic review of the literature.

MATERIALS AND METHODS: MEDLINE and EMBASE databases and Cochrane Database of Systematic Reviews were searched for relevant studies. Two reviewers independently assessed the methodological quality of each study. Summary receiver operating characteristic (ROC) analysis was used to summarize and compare the diagnostic accuracy of the three modalities.

RESULTS: Four studies with CT, 13 with endoscopic US, and seven with FDG PET met inclusion criteria. Percentages of the maximum score in regard to methodological quality ranged from 15% to 100%. Summary ROC analysis could be performed for three studies with CT, four with endoscopic US, and four with FDG PET. The maximum joint values for sensitivity and specificity were 54% for CT, 86% for endoscopic US, and 85% for FDG PET. Accuracy of CT was significantly lower than that of FDG PET (P < .006) and of endoscopic US (P < .003). Accuracy of FDG PET and that of endoscopic US were similar (P = .839). In all patients, CT was always feasible, whereas endoscopic US was not feasible in 6% of the patients, and FDG PET was not feasible in less than 1%.

CONCLUSION: CT has poor accuracy for assessment of response to neoadjuvant therapy in patients with esophageal cancer. Endoscopic US and FDG PET have equivalent good accuracy, but endoscopic US is not always feasible after chemotherapy and radiation therapy. FDG PET seems to be a promising noninvasive tool for assessment of neoadjuvant therapy in patients with esophageal cancer.

© RSNA, 2005

This article has been cited by other articles:

				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]

				L. Bedenne and F. Bonnetain In Reply J. Clin. Oncol., September 1, 2007; 25(25): 4026 - 4027. [Full Text] [PDF]

				G. Piessen, N. Briez, J.-P. Triboulet, and C. Mariette Patients with Locally Advanced Esophageal Carcinoma Nonresponder to Radiochemotherapy: Who Will Benefit From Surgery? Ann. Surg. Oncol., July 1, 2007; 14(7): 2036 - 2044. [Abstract] [Full Text] [PDF]

				W. A. Weber and R. Figlin Monitoring Cancer Treatment with PET/CT: Does It Make a Difference? J. Nucl. Med., January 1, 2007; 48(1_suppl): 36S - 44S. [Abstract] [Full Text] [PDF]

				S. Apisarnthanarax, M. M. Alauddin, F. Mourtada, H. Ariga, U. Raju, O. Mawlawi, D. Han, W. G. Bornmann, J. A. Ajani, L. Milas, et al. Early Detection of Chemoradioresponse in Esophageal Carcinoma by 3'-Deoxy-3'-3H-Fluorothymidine Using Preclinical Tumor Models Clin. Cancer Res., August 1, 2006; 12(15): 4590 - 4597. [Abstract] [Full Text] [PDF]