PET imaging for prediction of response to therapy and outcome in oesophageal carcinoma

Excerpt

Oesophageal carcinoma remains a major worldwide health challenge in the early twenty-first century. Five-year relative survival rates are highly stage dependent and range from up to 80% in stage I to less than 5% in stage IV [1]. Although resection, now usually preceded by neoadjuvant chemotherapy, is the only curative treatment option in most cases, associated mortality and morbidity rates remain high and accurate imaging of local invasion and regional nodal involvement is essential to guiding treatment. Using anatomical imaging techniques to assess local spread in oesophageal carcinoma is complicated by the inherent difficulties of visualizing an infiltrative tumour arising in a thin-walled structure, whose lymphatic drainage extends from cervical to abdominal nodal groups. Molecular imaging with ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography PET/CT has already proven a valuable addition to CT and endoscopic ultrasound in excluding distant metastatic spread which would preclude a curative therapeutic approach. …