Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
Nucl Med Commun. 2020 Sep;41(9):959-964. doi: 10.1097/MNM.0000000000001229.
The aim of the study was to evaluate diagnostic performance of FDG PET-CT in suspected recurrence of carcinoma esophagus after curative-intent surgical resection and impact of FDG PET-CT on intended management.
This was retrospective study of patients with clinical or radiological suspicion of recurrent esophageal carcinoma who were referred for PET-CT from January 2006 to December 2017. Diagnostic performance of PET-CT was evaluated for disease recurrence and its impact on management decisions. PET-CT findings were confirmed with tissue diagnosis. When tissue diagnosis was not available clinical and radiological follow-up was used as reference standard.
Relevant clinical data were available in 68 patients which were considered for analysis. In 91% (62/68) patients FDG PET-CT findings were suggestive of disease recurrence. Histopathological confirmation was available in 43 patients, whereas in remaining patients recurrence was confirmed by radiological and clinical follow-up. Forty percent (28/68) patients were detected with distant metastases. Sensitivity, specificity, positive and negative predictive values of FDG PET-CT was found to be 98.4, 80, 98 and 80% with accuracy of 97%. Change in management was observed in 41% (28/68) of patients from salvage radiotherapy/surgery to palliative chemotherapy/best supportive care based on evidence of distant metastases seen on FDG PET-CT.
FDG PET-CT is highly sensitive in detection of recurrent disease in esophageal cancer patients after surgical resection. It can detect distant metastases in high proportion of patients thus changing the intent of management from radical salvage to palliative chemotherapy/best supportive care.
本研究旨在评估氟代脱氧葡萄糖正电子发射断层扫描（FDG PET-CT）在根治性手术后怀疑食管癌复发患者中的诊断性能，以及 FDG PET-CT 对治疗计划的影响。
这是一项回顾性研究，纳入了 2006 年 1 月至 2017 年 12 月间因临床或影像学怀疑食管癌复发而接受 PET-CT 检查的患者。评估了 PET-CT 对疾病复发的诊断性能及其对治疗决策的影响。使用组织学诊断来确认 PET-CT 检查结果。当无法进行组织学诊断时，则采用临床和影像学随访作为参考标准。
68 例患者的相关临床数据可用于分析。在 91%（62/68）的患者中，FDG PET-CT 检查结果提示存在疾病复发。在 43 例患者中获得了组织学证实，而在其余患者中，通过影像学和临床随访证实了复发。40%（28/68）的患者检测到远处转移。FDG PET-CT 的敏感性、特异性、阳性预测值和阴性预测值分别为 98.4%、80%、98%和 80%，准确率为 97%。根据 FDG PET-CT 上观察到的远处转移证据，41%（28/68）的患者的治疗方案发生了改变，从挽救性放疗/手术改为姑息性化疗/最佳支持治疗。
FDG PET-CT 对检测根治性手术后食管癌患者的复发具有高度敏感性。它可以在很大比例的患者中检测到远处转移，从而改变治疗方案的意图，从根治性挽救治疗改为姑息性化疗/最佳支持治疗。
