Better assessment of nodal metastases by PET/CT fusion compared to side-by-side PET/CT in oesophageal cancer

Abstract

Background: Recently, positron emission tomography/computed tomography (PET/CT) has been introduced in the staging of oesophageal cancer. The impact of PET/CT fusion in comparison with side-by-side PET/CT in these tumours, was analyzed. Patients and Methods: In 61 patients, 18-F-fluorodeoxyglucose (FDG)-PET and multidetector (md)-CT were performed within a two week interval. Software-fusion of md-CT and FDG-PET was correlated with side-by-side FDG-PET/CT reading by two independent investigators. The gold standard was the pathological outcome or clinical evidence of progression during the first year of follow-up. Results: In 18 patients (18/61; 30%), nodal staging improved with software-fusion. The number of nodal metastases increased in five patients and decreased in four patients, leading to up-staging in one patient (2%) and down-staging in three patients (5%). In nine cases (15%), certainty and localization of metastases improved. However, the number of distant metastases did not change and software-fusion did not have an influence on resectability. Conclusion: PET/CT fusion substantially improves detection and localization of nodal metastases and may have an impact on locoregional treatment options