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Advantages of FDG-PET/CT over CT alone in the preoperative assessment of lymph node metastasis in patients with esophageal cancer

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An Erratum to this article was published on 18 February 2015

Abstract

Purpose

The aim of this study was to determine the benefits of 18F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) compared to CT alone in the preoperative assessment of lymph node metastasis in patients with esophageal cancer.

Methods

One-hundred and seven patients who underwent esophagectomy with lymph node dissection between March 2007 and December 2009 were eligible. Sixty-seven patients were treated with surgery alone (SA group), while 40 patients received preoperative treatment prior to surgery (PT group). The pathological results of 1,403 dissected lymph node stations were compared with the results obtained using each imaging modality.

Results

PET/CT showed a significantly higher specificity and positive predictive value (PPV) than CT alone (97.7 vs. 94.1 % and 64.6 vs. 44.0 %, respectively), when analyzed by the lymph node stations. The PPV of PET/CT for N1 cases was significantly better than that of CT alone (78.9 vs. 53.9 %), particularly in the PT group (91.3 vs. 65.4 %). Among the patients in the SA group, the number of metastatic nodes was significantly higher in PET-N1 cases than in PET-N0 cases (5.78 vs. 1.90).

Conclusion

PET/CT is useful for selecting patients with multiple lymph node metastases and also for detecting residual metastatic nodes after PT, and thus is beneficial to decide on the appropriate treatment strategy for patients with esophageal cancer.

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Acknowledgments

The authors thank Dr. Shinya Shiraishi (Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences) for his suggestions during the early days of the study and Dr. Morikatsu Yoshida (Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences) for the information about the imaging conditions.

Conflict of interest

The authors have no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Ryuichi Karashima, Masayuki Watanabe, Yu Imamura, Satoshi Ida, Yoshifumi Baba, Shiro Iwagami, Yuji Miyamoto, Yasuo Sakamoto, Naoya Yoshida & Hideo Baba

  2. Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Masayuki Watanabe

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  1. Ryuichi Karashima
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  2. Masayuki Watanabe
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  3. Yu Imamura
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  5. Yoshifumi Baba
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  10. Hideo Baba
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Correspondence to Masayuki Watanabe.

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Karashima, R., Watanabe, M., Imamura, Y. et al. Advantages of FDG-PET/CT over CT alone in the preoperative assessment of lymph node metastasis in patients with esophageal cancer. Surg Today 45, 471–477 (2015). https://doi.org/10.1007/s00595-014-0965-6

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  • DOI: https://doi.org/10.1007/s00595-014-0965-6

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