The role of PET scan in the preoperative management of oesophageal cancer

Aim The aim of this study was to evaluate the role of the 18F-FDG-PET in the preoperative evaluation of patients with oesophageal or gastro-oesophageal junction (GEJ) cancer and to define its impact on therapeutic management. Patients and methods This study included 58 patients with biopsy proven oesophageal or GEJ cancer who underwent PET in addition to the conventional diagnostic work-up. The sensitivity, specificity and accuracy of CT and PET were calculated for detection of tumour and distant metastases. Results The sensitivity, specificity and accuracy of tumour detection were, respectively, 84, 100 and 84% for CT and 87, 100 and 87% for PET (p=ns). PET permitted detection of distant metastases, which were not seen on CT in seven patients. In two patients, a second primary tumour was detected on PET. Conclusions The sensitivity of PET for loco regional lymph nodes detection is low. The major clinical impact is the detection of distant metastases.