Role of FDG-PET scan in staging of cancer of the esophagus and gastroesophageal junction.

BACKGROUND

FDG-PET scan has generated in recent years an increasing interest in staging and assessment of response to treatment in cancer patients.

METHODS

From the available literature and own data it appears that FDG-PET scan significantly improves detection of haematogenous and distant lymphatic metastasis in carcinoma of the oesophagus and gastro-oesophageal junction (GEJ). Especially diagnostic specificity of lymph node involvement is greatly improved with FDG-PET scan. FDG-PET scan also allows a highly sensitive diagnosis of recurrent disease through its capacity of whole-body staging. In assessing response of induction (chemo +/- radiotherapy) in locally advanced disease FDG-PET scan appears to be of high value in predicting response.

RESULTS

Moreover, there seems to be a strong correlation between FDG-PET scan response and survival.

CONCLUSIONS

It can be concluded that despite the cost, FDG-PET scan should have a place in the algorithm of initial staging, staging of recurrent disease and assessment of response to treatment in cancer of the oesophagus and GE junction.