Abstract:

Objective  To investigate the clinical effect of contrast-enhanced multiple-detector spiral computed tomography (MDCT) in combination with FDG PET/CT on esophageal cancer staging.  Methods  MDCT and FDG PET/CT were performed and prospectively interpreted in 79 patients with newly diagnosed esophageal cancer within one week. Primary lesions，invasion of adjacent structures, locations and numbers of metastases to the individual lymph node groups were observed. All the lesions were histopathologically confirmed. Results of MDCT, PET/CT and their combination were compared with histopathological results.  Results  Lesion detective rate was 78.3% by MDCT, 96.4%by PET/CT, and 96.4% by their combination. Sensitivity, specificity and accuracy for T4 staging tumors was 70.0%, 94.5% and 91.6% by MDCT, 90%, 68.5% and 71.1% by PET/CT, 90%, 98.6% and 97.6% by their combination. Differences in specificity(P=0.0) andaccuracy(P=0.0) between PET/CT alone and MDCT in combination with PET/CT were statistically  significant. For detecting lymph nodes metastases, the sensitivity, specificity and accuracy by MDCT was 70.5%, 95.9%, and 90.1%, and by FDG PET/CT was 86.1％, 97.1%, and 94.6%,whereas by their combination was 94.3%, 98.6%, and 97.6%. Differences in sensitivity （P=0.0）, specificity（P=0.007） and accuracy（P=0.0）between MDCT alone and MDCT in combination with PET/CT were significant, also differences in sensitivity（P=0.021） and accuracy（P=0.004）between PET/CT alone and MDCT in combination with PET/CT were obviously significant.  Conclusion Diagnosis and staging of oesophageal cancer can be improved by using both FDG PET/CT and MDCT at the same time.

Key words: Esophageal Neoplasms, staging; Tomography, Emission-computed; Deoxyglucose; Tomography, X-ray computed