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Diagnostic value of surveillance 18F-fluorodeoxyglucose PET/CT for detecting recurrent esophageal carcinoma after curative treatment

  • Soo Jeong Kim
  • Seung Hyup Hyun
  • Seung Hwan Moon
  • Kyung Soo Lee
  • Jong-Mu Sun
  • Dongryul Oh
  • Yong Chan Ahn
  • Jae Il Zo
  • Young Mog Shim
  • Joon Young ChoiEmail author
Original Article
  • 314 Downloads
Part of the following topical collections:
  1. Oncology – Digestive tract

Abstract

Purpose

Esophageal carcinoma recurs within two years in approximately half of patients who receive curative treatment and is associated with poor survival. While 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a reliable method of detecting recurrent esophageal carcinoma, in most previous studies FDG PET/CT scans were performed when recurrence was suspected. The aim of this study was to evaluate FDG PET/CT as a surveillance modality to detect recurrence of esophageal carcinoma after curative treatment where clinical indications of recurrent disease are absent.

Methods

A total of 782 consecutive FDG PET/CT studies from 375 patients with esophageal carcinoma after definitive treatment were reviewed. Abnormal lesions suggestive of recurrence on PET/CT scans were then evaluated. Recurrence was determined by pathologic confirmation or other clinical evidence within two months of the scan. If no clinical evidence for recurrence was found at least 6 months after the scan, the case was considered a true negative for recurrence.

Results

The diagnostic sensitivity and specificity of PET/CT for detecting recurrent esophageal carcinomas were 100% (64/64) and 94.0% (675/718), respectively. There were no significant differences in the diagnostic performance of PET/CT for detecting recurrence according to initial stage or time between PET/CT and curative treatments. Unexpected second primary cancers were detected by FDG PET/CT in seven patients.

Conclusions

Surveillance FDG PET/CT is a useful imaging tool for detection of early recurrence or clinically unsuspected early second primary cancer in patients with curatively treated esophageal carcinoma but without clinical suspicion of recurrence.

Keywords

Esophageal cancer Surveillance Nuclear medicine 18F-fluorodeoxyglucose PET/CT 

Notes

Acknowledgments

This paper was supported by the following grant(s): The National R&D Program for Cancer Control, Ministry of Health & Welfare, Korea (1720180).

Funding

This study was funded by The National R & D Program for Cancer Control, Ministry of Health & Welfare, Korea (grant number 1720180).

Compliance with ethical standards

Conflict of interest

All authors declare they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. 1.
    Mariette C, Balon JM, Piessen G, Fabre S, Van Seuningen I, Triboulet JP. Pattern of recurrence following complete resection of esophageal carcinoma and factors predictive of recurrent disease. Cancer. 2003;97(7):1616–23.  https://doi.org/10.1002/cncr.11228.CrossRefPubMedGoogle Scholar
  2. 2.
    Blom RL, Lagarde SM, van Oudenaarde K, Klinkenbijl JH, Hulshof MC, van Laarhoven HW, et al. Survival after recurrent esophageal carcinoma has not improved over the past 18 years. Ann Surg Oncol. 2013;20(8):2693–8.  https://doi.org/10.1245/s10434-013-2936-3.CrossRefPubMedGoogle Scholar
  3. 3.
    Hamai Y, Hihara J, Emi M, Furukawa T, Ibuki Y, Yamakita I, et al. Treatment outcomes and prognostic factors after recurrence of esophageal squamous cell carcinoma. World J Surg. 2018;42(7):2190-2198.  https://doi.org/10.1007/s00268-017-4430-8.
  4. 4.
    Yamashita K, Watanabe M, Mine S, Kurogochi T, Okamura A, Hayami M, et al. Patterns and outcomes of recurrent esophageal cancer after curative esophagectomy. World J Surg. 2017;41(9):2337–44.  https://doi.org/10.1007/s00268-017-4024-5.CrossRefPubMedGoogle Scholar
  5. 5.
    Schizas D, Lazaridis II, Moris D, Mastoraki A, Lazaridis LD, Tsilimigras DI, et al. The role of surgical treatment in isolated organ recurrence of esophageal cancer-a systematic review of the literature. World J Surg Oncol. 2018;16(1):55.  https://doi.org/10.1186/s12957-018-1357-y.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Zhou YQ, Ding NX, Wang LJ, Liu W, Jiang M, Lu JC. Salvage radiochemotherapy for lymph node recurrence after radical surgery of esophageal cancer. Medicine. 2018;97(5):e9777.  https://doi.org/10.1097/md.0000000000009777.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Ajani JA, D’Amico TA, Almhanna K, Bentrem DJ, Besh S, Chao J, et al. Esophageal and esophagogastric junction cancers, version 1. 2015. Journal of the National Comprehensive Cancer Network : JNCCN. 2015;13(2):194–227.CrossRefPubMedGoogle Scholar
  8. 8.
    Nakagawa S, Kanda T, Kosugi S, Ohashi M, Suzuki T, Hatakeyama K. Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy. J Am Coll Surg. 2004;198(2):205–11.  https://doi.org/10.1016/j.jamcollsurg.2003.10.005.CrossRefPubMedGoogle Scholar
  9. 9.
    Lee SJ, Lee KS, Yim YJ, Kim TS, Shim YM, Kim K. Recurrence of squamous cell carcinoma of the oesophagus after curative surgery: rates and patterns on imaging studies correlated with tumour location and pathological stage. Clin Radiol. 2005;60(5):547–54.  https://doi.org/10.1016/j.crad.2004.09.002.CrossRefPubMedGoogle Scholar
  10. 10.
    Goense L, van Rossum PS, Reitsma JB, Lam MG, Meijer GJ, van Vulpen M, et al. Diagnostic performance of (18)F-FDG PET and PET/CT for the detection of recurrent esophageal cancer after treatment with curative intent: a systematic review and meta-analysis. J Nucl Med. 2015;56(7):995–1002.  https://doi.org/10.2967/jnumed.115.155580.CrossRefPubMedGoogle Scholar
  11. 11.
    Choi SH, Kim YT, Kim SK, Kang KW, Goo JM, Kang CH, et al. Positron emission tomography-computed tomography for postoperative surveillance in non-small cell lung cancer. Ann Thorac Surg. 2011;92(5):1826–32. discussion 32.  https://doi.org/10.1016/j.athoracsur.2011.07.005.CrossRefPubMedGoogle Scholar
  12. 12.
    Marcus C, Paidpally V, Antoniou A, Zaheer A, Wahl RL, Subramaniam RM. 18F-FDG PET/CT and lung cancer: value of fourth and subsequent posttherapy follow-up scans for patient management. J Nucl Med. 2015;56(2):204–8.  https://doi.org/10.2967/jnumed.114.147884.CrossRefPubMedGoogle Scholar
  13. 13.
    Dunsky KA, Wehrmann DJ, Osman MM, Thornberry BM, Varvares MA. PET-CT and the detection of the asymptomatic recurrence or second primary lesions in the treated head and neck cancer patient. Laryngoscope. 2013;123(9):2161–4.  https://doi.org/10.1002/lary.23941.CrossRefPubMedGoogle Scholar
  14. 14.
    Brooks RA, Rader JS, Dehdashti F, Mutch DG, Powell MA, Thaker PH, et al. Surveillance FDG-PET detection of asymptomatic recurrences in patients with cervical cancer. Gynecol Oncol. 2009;112(1):104–9.  https://doi.org/10.1016/j.ygyno.2008.08.028.CrossRefPubMedGoogle Scholar
  15. 15.
    Madu MF, Timmerman P, Wouters M, van der Hiel B, van der Hage JA, van Akkooi ACJ. PET/CT surveillance detects asymptomatic recurrences in stage IIIB and IIIC melanoma patients: a prospective cohort study. Melanoma Res. 2017;27(3):251–7.  https://doi.org/10.1097/CMR.0000000000000347.CrossRefPubMedGoogle Scholar
  16. 16.
    Lee JW, Lee SM, Son MW, Lee MS. Diagnostic performance of FDG PET/CT for surveillance in asymptomatic gastric cancer patients after curative surgical resection. Eur J Nucl Med Mol Imaging. 2016;43(5):881–8.  https://doi.org/10.1007/s00259-015-3249-5.CrossRefPubMedGoogle Scholar
  17. 17.
    Suh YS, Han DS, Kong SH, Lee HJ, Kim YT, Kim WH, et al. Should adenocarcinoma of the esophagogastric junction be classified as esophageal cancer? A comparative analysis according to the seventh AJCC TNM classification. Ann Surg. 2012;255(5):908–15.  https://doi.org/10.1097/SLA.0b013e31824beb95.CrossRefPubMedGoogle Scholar
  18. 18.
    Choi JY, Jang HJ, Shim YM, Kim K, Lee KS, Lee KH, et al. 18F-FDG PET in patients with esophageal squamous cell carcinoma undergoing curative surgery: prognostic implications. J Nucl Med. 2004;45(11):1843–50.PubMedGoogle Scholar
  19. 19.
    Betancourt Cuellar SL, Palacio DP, Wu CC, Carter BW, Correa AM, Hofstetter WL, et al. (18)FDG-PET/CT is useful in the follow-up of surgically treated patients with oesophageal adenocarcinoma. Br J Radiol. 2018;91(1082):20170341.  https://doi.org/10.1259/bjr.20170341.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Mariette C, Taillier G, Van Seuningen I, Triboulet JP. Factors affecting postoperative course and survival after en bloc resection for esophageal carcinoma. Ann Thorac Surg. 2004;78(4):1177–83.  https://doi.org/10.1016/j.athoracsur.2004.02.068.CrossRefPubMedGoogle Scholar
  21. 21.
    Teyton P, Metges JP, Atmani A, Jestin-Le Tallec V, Volant A, Visvikis D, et al. Use of positron emission tomography in surgery follow-up of esophageal cancer. J Gastrointest Surg. 2009;13(3):451–8.  https://doi.org/10.1007/s11605-008-0749-7.CrossRefPubMedGoogle Scholar
  22. 22.
    Lou F, Sima CS, Adusumilli PS, Bains MS, Sarkaria IS, Rusch VW, et al. Esophageal cancer recurrence patterns and implications for surveillance. J Thorac Oncol. 2013;8(12):1558–62.  https://doi.org/10.1097/01.JTO.0000437420.38972.fb.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Yamaguchi T, Kato K, Nagashima K, Iwasa S, Honma Y, Takashima A, et al. Type of second primary malignancy after achieving complete response by definitive chemoradiation therapy in patients with esophageal squamous cell carcinoma. Int J Clin Oncol. 2018;23(4):652-658.  https://doi.org/10.1007/s10147-018-1258-7.
  24. 24.
    Roh JL, Park JP, Kim JS, Lee JH, Cho KJ, Choi SH, et al. 18F fluorodeoxyglucose PET/CT in head and neck squamous cell carcinoma with negative neck palpation findings: a prospective study. Radiology. 2014;271(1):153–61.  https://doi.org/10.1148/radiol.13131470.CrossRefPubMedGoogle Scholar
  25. 25.
    Choi JY, Lee KS, Kwon OJ, Shim YM, Baek CH, Park K, et al. Improved detection of second primary cancer using integrated [18F] fluorodeoxyglucose positron emission tomography and computed tomography for initial tumor staging. J Clin Oncol. 2005;23(30):7654–9.  https://doi.org/10.1200/JCO.2005.01.4340.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Soo Jeong Kim
    • 1
  • Seung Hyup Hyun
    • 2
  • Seung Hwan Moon
    • 2
  • Kyung Soo Lee
    • 3
  • Jong-Mu Sun
    • 4
  • Dongryul Oh
    • 5
  • Yong Chan Ahn
    • 5
  • Jae Il Zo
    • 6
  • Young Mog Shim
    • 6
  • Joon Young Choi
    • 2
    Email author
  1. 1.Department of Nuclear Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulRepublic of Korea
  2. 2.Department of Nuclear Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  3. 3.Department of Radiology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  4. 4.Division of Hematology-Oncology Department of Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  5. 5.Department of Radiation Oncology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
  6. 6.Thoracic and Cardiovascular Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea

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