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Diagnostic value of 18F-FDG PET/CT for lymph node metastasis of esophageal squamous cell carcinoma

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Abstract

Purpose

This study investigated the diagnostic accuracy of hybrid positron-emission tomography/computed tomography (PET/CT) for lymph node (LN) metastasis of esophageal cancer. We also investigated the correlation between the size of metastatic nests and the detection by PET/CT.

Methods

Two hundred and fifty-eight patients with esophageal squamous cell carcinoma who underwent esophagectomy with two- or three-field radical lymphadenectomy were analyzed retrospectively. We compared the diagnosis of preoperative PET/CT to the postoperative histopathological examination by each anatomical field (n = 1,231) in all 258 patients. The metastatic LNs resected from PET/CT positive fields were classified as belonging to the PET/CT-N-positive group (n = 229) and those from negative fields as belonging to the PET/CT-N-negative group (n = 352). The cross-sectional areas of metastatic nests were measured in each metastatic LN.

Results

Of the 1,231 fields, 275 (22 %) were positive for metastasis, including 581 LNs from 408 regional LN stations. The sensitivity and specificity of PET/CT examined by each anatomical field were 25.8 and 97.8 %, respectively. The median area of metastatic nests was 17.7 mm2 in the PET/CT-N-positive group, and 7.7 mm2 in the PET/CT-N-negative group (p < 0.001).

Conclusions

A significant correlation was suggested between the nest size and detection by PET/CT. Because of its low sensitivity, PET/CT alone is insufficient to determine the surgical procedures, especially when considering reduction surgery.

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Conflict of interest

We declare no potential conflicts of interest in association with this study.

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Authors and Affiliations

  1. Department of Digestive Surgery, Keiyukai Sapporo Hospital, 1, 14 cho-me kita, Hondori, Shiroishi-ku, Sapporo, 003-0027, Japan

    Hiroyuki Yamada, Masao Hosokawa, Yoshihiro Kinoshita, Tomohiro Kikkawa, Keita Sakashita, Shion Uemura, Yasunori Nishida & Takaya Kusumi

  2. Center of Radiological Image, Keiyukai Sapporo Hospital, Sapporo, Japan

    Kazuo Itoh

  3. Department of Surgical Pathology, Keiyukai Sapporo Hospital, Sapporo, Japan

    Toshinao Takenouchi

  4. Division of Medical Science, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan

    Shigeyuki Sasaki

Authors
  1. Hiroyuki Yamada
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  2. Masao Hosokawa
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  3. Kazuo Itoh
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  4. Toshinao Takenouchi
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  5. Yoshihiro Kinoshita
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  6. Tomohiro Kikkawa
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  7. Keita Sakashita
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  8. Shion Uemura
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  9. Yasunori Nishida
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  10. Takaya Kusumi
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  11. Shigeyuki Sasaki
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Correspondence to Hiroyuki Yamada.

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Yamada, H., Hosokawa, M., Itoh, K. et al. Diagnostic value of 18F-FDG PET/CT for lymph node metastasis of esophageal squamous cell carcinoma. Surg Today 44, 1258–1265 (2014). https://doi.org/10.1007/s00595-013-0725-z

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  • DOI: https://doi.org/10.1007/s00595-013-0725-z

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