Impact of 18F-FDG PET/CT on the therapeutic management in the initial staging of the esophageal cancer

Objective: The incidence of esophageal cancer has increased considerably over recent years, it now being the 6(th) most frequent cause of cancer-related death. Our study has aimed to compare the clinical value of PET/CT and CT scan in the initial staging of patients with esophageal cancer. Material and methods: Fifty nine patients (6 women) diagnosed of esophageal cancer were assessed retrospectively. All patients underwent diagnostic CT scan and PET/CT for initial staging within 3 to 15 days following clinical diagnosis. Results: PET/CT showed intracellular F-18-FDG entrapment having pathological significance in all the tumors (100%), signs of locoregional lymph node infiltration (N1) in 34 and a total of 19 lesions consistent with metastasis (M1) in 14 patients (23.72%). The CT scan detected malignancy in 57 patients (96.6%), abnormal lymph node in 32 patients and 17 N1 in 12 patients (20.33%). In three cases, CT- PET detected synchronous esophageal lesion in staging studies for other neoplastic processes (lung and ear-nose-throat). Conclusion: PET/CT showed a higher detection rate of primary malignant lesions, abnormal lymph nodes and distant metastases. A change in stage was only observed in two patients. (C) 2008 Elsevier Espana, S.L. and SEMN. All rights reserved.