Objective: The purpose of this study was to evaluate fludeoxyglucose-positron emission tomography/CT's (FDG-PET/CT) performance in the follow up of patients with surgically treated oesophageal adenocarcinoma. Methods: The follow-up FDG-PET/CT scans of 162 consecutive patients with surgically treated oesophageal adenocarcinoma were retrospectively reviewed. Histopathological and/or imaging examinations confrmed recurrent disease. The accuracy, sensitivity, specifcity and negative and positive predictive values were calculated. Results: Recurrence occurred in 71 (43%) patients, usually within the frst year following surgery (60%) and in more than one site (76%). The sensitivity, specifcity, positive-predictive value, negative-predictive value and accuracy of FDG-PET/CT for anastomotic recurrence were 77, 76, 16, 98 and 76%; for regional nodal recurrence were 88, 85, 43, 97 and 86%; and for distant metastatic recurrence were: 97, 96, 91, 99 and 96%. In 5 of the 42 patients (12%) with distant metastases, the metastatic sites were outside the area covered by a conventional follow-up chest-abdomen CT and in 4 patients (9%) metastases were barely perceptible on the CT component of the FDG-PET/CT and consequently were unlikely to be detected without the aid of the FDG uptake. Conclusion: FDG PET/CT is accurate in detecting oesophageal adenocarcinoma recurrence, especially within the frst post-operative year when most recurrences occur, and is useful in identifying patients with a solitary metastasis. Advances in knowledge: FDG-PET/CT should be considered as a valuable tool in the routine follow up of surgically treated oesophageal cancer patients within the frst 2 years after surgery.
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging