PET/CT imaging in diagnosing lymph node metastasis of esophageal carcinoma and its comparison with pathological findings

G.-M. Wang, D.-F. Liu, Y.-P. Xu, T. Meng, F. Zhu

Department of Nuclear Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, China. w_guanmin@163.com

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• Oncology

OBJECTIVE: To investigate the usefulness of ¹⁸F-FDG PET/CT imaging in the diagnosis of lymph node metastasis of esophageal carcinoma and to compare its results with pathological findings.

PATIENTS AND METHODS: This study examined 43 cases of patients (32 males and 11 females, aged 54 ± 13 years old) being diagnosed with lymph node metastasis of esophageal carcinoma in our hospital between 2005 and 2014. All of these patients accepted ¹⁸F-FDG PET/CT imaging 10 days before the operation. Before reconstruction, each patient went through the body scan. PET/CT images were subject to comprehensive diagnostic analyses, by three experienced radiologists and/or professional nuclear physicians, on the number of metastatic lymph nodes and the maximum standardized uptake value (SUV_max). A control study was also performed on the pathological findings according to the latest esophageal cancer lymph node partition.

RESULTS: A total of 846 lymph nodes were taken out from the patients, among which 154 were confirmed with metastasis. When the SUV_max cutoff values were set at 2.5 and 5, 201 and 173 metastatic lymph nodes were found by ¹⁸F-FDG PET/CT imaging, respectively. Additionally, under such condition, ¹⁸F-FDG PET/CT imaging had the esophageal sensitivity of 69.48% vs 87.66%, specificity of 92.71% vs 94.51%, accuracy of 83.33% vs 93.26%, positive predictive value of 53.23% vs 78.03%, and negative predictive value of 92.71% vs 97.18%.

CONCLUSIONS: ¹⁸F-FDG PET/CT had high accuracy in imaging lymph node metastasis of esophageal cancer. SUV_max cutoff value of 5 had a higher diagnostic accuracy and should be recommended in clinical practice.

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