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Nuklearmedizin 2006; 45(06): 235-241
DOI: 10.1055/s-0038-1625108
Originalarbeiten – Original Articles
Schattauer GmbH

FDG-PET in the initial staging of squamous cell oesophageal carcinoma

FDG-PET zum initialen Staging bei Plattenepithelkarzinom des Ösophagus
I. Buchmann
1   Department of Nuclear Medicine
,
T. Hansen
2   Department of Institute of Pathology, University Hospital Jena
3   Department of Institute of Pathology, University Hospital Jena, Mainz, Germany
,
C. Brochhausen
3   Department of Institute of Pathology, University Hospital Jena, Mainz, Germany
,
W. Kneist
4   Department of Surgery, Radiology, University Hospital Mainz
,
K. Oberholzer
5   Department of Radiology, University Hospital Mainz
,
T. Junginger
4   Department of Surgery, Radiology, University Hospital Mainz
,
M. Schreckenberger
1   Department of Nuclear Medicine
,
P. Bartenstein
1   Department of Nuclear Medicine
› Author Affiliations
Further Information

Publication History

Received: 03 February 2006

in revised form: 23 August 2006

Publication Date:
11 January 2018 (online)

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Summary

Squamous cell oesophageal carcinoma is the most common carcinoma of the oesophagus worldwide. The tumour stage as most important prognostic factor determines the clinical management. Aim of this study was to evaluate the value of FDG-PET 1. in imaging the primary tumour and 2. in Nand M-staging of squamous cell oesophageal carcinoma. Patients, methods: In 20 patients with histological proven squamous cell carcinoma of the upper and middle oesophagus , FDG-PET was performed in standard technique prior to therapy. FDG uptake in the primary was determined by calculation of the SUVmax. NM-staging due to PET findings was performed as designated by the AJCC/UICC group classification and was compared with pathological and clinically based staging. Sensitivities, specificities and accuracies were calculated. Results: In 19 of 20 patients, primary squamous cell oesopohageal carcinoma was detected by FDG-PET findings with a maximum SUV of 12.5 (mean) ± 5.1 (median 11.5; range 4.8-23.8). One carcinoma in situ was missed. The sensitivity of FDG-PET in imaging the primary tumour was 96%. The sensitivities, specificities and accuracies were 20%, 100%, 58% for N-staging, and 60%, 86% and 93% for M-staging. PET findings caused changes of therapy in 5% (1 patient). Conclusions: FDGPET was excellent in imaging the primary of squamous cell oesophageal carcinoma in stage T1-T4 and was efficient in M-staging. The low sensitivity in N-staging is of inferior clinical importance. The efficacy of FDG-PET seems to be not significantly be influenced by the histological subtype of oesophageal carcinoma.

Zusammenfassung

Das Plattenepithelkarzinom ist das weltweit häufigste Karzinom des Ösophagus. Das Tumor-Staging als wesentlichster prognostischer Faktor bestimmt das klinische Management. Ziel unserer Studie war die Evaluation der Wertigkeit der FDG-PET im Nachweis des Primärtumors sowie im Nund M-Staging unter ausschließlicher Berücksichtigung des Plattenepithelkarzinoms. Patienten, Methoden: In 20 Patienten mit histologisch gesichertem Plattenepithelkarzinom des oberen und mittleren Ösophagus wurde eine FDGPET in Standardtechnik und vor Therapieeinleitung durchgeführt und die FDG-Aufnahme in den Primärtumor durch Berechnung des SUVmax quantifiziert. Das NM-Staging der PET-Befunde erfolgte gemäß der Zuordnung der AJCC/ UICC group und wurde mit dem pathologischen und klinischen Staging verglichen. Sensitivitäten, Treffsicherheiten und Spezifitäten wurden errechnet. Ergebnisse: In 19/20 Patienten stellte sich der Primärtumor des Ösophagus mit einem SUVmax von 12,5 (Mittelwert) ± 5,1 (Median 11,5; Bereich 4,8-23,8) dar. Ein Karzinom in situ wurde nicht nachgewiesen. Die Sensitivität der FDG-PET im Nachweis des primären Ösophaguskarzinoms betrug 96%. Die Sensitivitäten, Spezifitäten und Treffsicherheiten waren 20%, 100%, 58% für das N-staging und 60%, 93%, 86% für das M-staging. Eine Änderung der Therapie durch den PET-Befund erfolgte in 5% der Fälle (1 Patient). Schlussfolgerung: FDG-PET ist exzellent im Nachweis des primären Plattenepithelkarzinoms des Ösophagus in den Stadien T1-T4 und effizient im M-staging. Daher werden vermutlich insbesondere jene Patienten von einer FDG-PET profitieren, deren Tumorstadium vorab als lokal resektabel, jedoch fortgeschritten beurteilt wurde: Bei Zuordnung in das Stadium IV sollte initial ein aggressiveres Therapieschema gewählt werden. Die geringe Sensitivität im N-staging besitzt klinisch eine untergeordnete Bedeutung. Die Effizienz der FDG-PET wird durch den histologischen Subtyp nicht maßgeblich beeinflusst.

Keywords

Squamous cell carcinoma - oesophageal cancer - tumour staging - FDG-PET - metastases

Schlüsselwörter

Plattenepithelkarzinom - Ösophaguskarzinom - Staging - FDG-PET - Metastasierung
 

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