TY - JOUR T1 - Assessment of lymph node metastases using 18F-FDG PET/CT and contrast enhanced CT in patients with esophageal cancer JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1400 LP - 1400 VL - 56 IS - supplement 3 AU - Andrej Doma AU - Matevž Srpčič AU - Daša Šfiligoj AU - Marko Grmek Y1 - 2015/05/01 UR - http://jnm.snmjournals.org/content/56/supplement_3/1400.abstract N2 - 1400 Objectives To evaluate diagnostic performance of 18F-FDG PET/CT and contrast enhanced CT (CECT) in the detection of lymph node (LN) metastases of esophageal carcinoma.Methods We retrospectively analyzed data of 50 esophageal carcinoma patients (male/female: 43/7, Age: 66,5±17,4), who underwent preoperative PET/CT between 2010 and 2014. PET/CT imaging was performed on Seimens Biograph mCT according to EANM procedure guidelines. Images were reevaluated by two nuclear medicine physicians in consensus, blinded to all details except for primary diagnosis. Preoperative CECT was available in 49 of 50 patients. Histopathology data of resected LN served as a gold standard. Histological subtypes included adenocarcinoma (n=26), squamous (n=22), basaloid squamous (n=1), and mucoepidermoid carcinoma (n=1).Results 18F-FDG PET/CT detected primary site in 45 of 50 (90%), failing to identify primary lesion in 5 of 14 T1 tumors. CECT detected all primary tumors. Histopathology proved LN metastases in 27 of 50 (54%) patients. Sensitivity (SE) and specificity (SP) on per-patient basis of PET/CT versus CECT to detect infiltrated LN were 52% vs. 21%, and 74% vs. 93%, respectively. Positive predictive value (PPV), negative predictive value (NPV) and accuracy (ACC) of PET/CT versus CECT for LN metastases were 70% vs. 88%, 57% vs. 34%, and 62% vs. 43%, respectively.CECT was negative for LN metastases in 31 of 49 (63%) and nondiagnostic in 10 of 49 (20%) patients. Histopatology revealed LN metastases in 20 of 41 patients with nondiagnostic or negative CECT. In patients with nondiagnostic or negative CECT, PET/CT correctly upstaged LN status in 7 of 20 (35%) and the rate of PET/CT false negatives was 32% (13 of 41).Conclusions 18F-FDG PET/CT offers higher sensitivity and accuracy over CECT in detecting metastatic LN in esophageal carcinoma patients. PET/CT correctly upstaged 7 of 20 patients in whom CECT for LN status was either false negative or inconclusive. ER -