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Ann Thorac Surg 1999;68:1133-1136
© 1999 The Society of Thoracic Surgeons

Original Articles

Evaluation of distant metastases in esophageal cancer: 100 consecutive positron emission tomography scans

James D. Luketich, MDa, David M. Friedman, BSa, Tracey L. Weigel, MDa, Mindi A. Meehan, BAa, Robert J. Keenan, MDa, David W. Townsend, PhDa, Carolyn C. Meltzer, MDa

a Section of Thoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

Address reprint requests to Dr Luketich, Section of Thoracic Surgery, University of Pittsburgh Medical Center, 200 Lothrop St, C-800 PUH, Pittsburgh, PA 15213
e-mail: luketichjd{at}msx.upmc.edu

Presented at the Thirty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Antonio, TX, Jan 25–27, 1999.

Background. Pilot studies suggest positron emission tomography (PET) scanning may be superior to conventional imaging in staging esophageal cancer, especially in the detection of radiographically occult distant metastases. This report summarizes our experience with PET in staging esophageal cancer.

Methods. One hundred consecutive PET scans in 91 patients with esophageal cancer referred for surgery were prospectively collected (1995 to 1998) and compared with computerized tomography (CT) and bone scan. PET images were acquired after injection of 18F-fluorodeoxyglucose and evaluated for abnormal uptake. Minimally invasive surgical staging (MIS) and/or clinical correlation were used to confirm or refute imaging results.

Results. MIS or clinical correlation confirmed 70 distant metastases in 39 cases. PET detected 51 metastases in 27 of 39 cases (69% sensitivity, 93.4% specificity, 84% accuracy) compared with CT, which detected 26 metastases in 18 of 39 cases (46.1% sensitivity, 73.8% specificity, 63% accuracy) (p < 0.01).

Conclusions. PET was more accurate than CT in detecting distant metastases, but was only 69% sensitive compared with minimally invasive staging.




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