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Can hybrid FDG-PET/CT detect subclinical lymph node metastasis of esophageal cancer appropriately and contribute to radiation treatment planning? A comparison of image-based and pathological findings

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Title: Can hybrid FDG-PET/CT detect subclinical lymph node metastasis of esophageal cancer appropriately and contribute to radiation treatment planning? A comparison of image-based and pathological findings
Authors: Shimizu, Shinichi Browse this author →KAKEN DB
Hosokawa, Masao Browse this author
Itoh, Kazuo Browse this author →KAKEN DB
Fujita, Masahiro Browse this author
Takahashi, Hiroaki Browse this author
Shirato, Hiroki Browse this author →KAKEN DB
Keywords: FDG
PET–CT
Esophageal cancer
Radiotherapy
Issue Date: Oct-2009
Publisher: Springer
Journal Title: International Journal of Clinical Oncology
Volume: 14
Issue: 5
Start Page: 421
End Page: 425
Publisher DOI: 10.1007/s10147-009-0893-4
PMID: 19856050
Abstract: Background. We aimed to determine the appropriateness of adding 18F-fl uorodeoxyglucose (FDG) -positronemission tomography (PET) to computed tomography (CT) and other pre-existing diagnostic imaging modalities for detecting subclinical lymph node metastasis of esophageal cancer, by comparing images from these modalities with the results of histopathological analysis. Methods. Twenty patients who received radical surgery for squamous cell carcinoma of the esophagus were examined by PET-CT, and endoscopic ultrasound (EUS) examination before surgery. Based on these diagnostic modalities, the clinical target volume (CTV) was set as the gross tumor volume (GTV) plus a 1-cm margin. Histopathological diagnosis was performed in all patients immediately after resection. Results. Fifty-three (3.0%) of 1764 nodes in the 20 patients were histopathologically positive for cancer cells. The CTV was not adequate to cover these histopathologically detected positive lymph nodes in 8 of 20 patients on CT, 5 of 20 on CT+EUS, 7 of 20 on PET-CT, and 5 of 20 on PET-CT+EUS. Conclusion. The detection rate of subclinical lymph node metastasis did not improve with the use of PET-CT, for either the cervical and supraclavicular, mediastinal, or abdominal regions. It is not recommended to use FDG-PET or PET-CT alone as a diagnostic tool to determine CTV if pathologically involved lymphatic regions are to be included in the CTV in the treatment protocol. The accuracy of PETCT must be further improved in order to better detect positive nodes and improve the defi nition of the CTV.
Rights: The final publication is available at link.springer.com
Type: article (author version)
URI: http://hdl.handle.net/2115/56599
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 清水 伸一

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