PET/MRI Promising for Esophageal Cancer Staging

Preoperative imaging of patients with esophageal cancer by PET and MRI may provide higher accuracy in nodal staging.

Compared with endoscopic ultrasound (EUS), PET/MR imaging may provide higher accuracy in nodal staging of esophageal cancer, according to a study published in the Journal of Nuclear Medicine.

Researchers from Pusan National University Hospital in Korea undertook a prospective study to compare the results of EUS, CT, PET/MR imaging and PET/CT for the preoperative local and regional staging of esophageal cancer, with postoperative pathologic stage used as the reference standard.

Nineteen patients (15 men) with newly diagnosed resectable esophageal cancer participated in the study. All underwent preoperative EUS, CT, PET/CT and PET/MR imaging. The images were reviewed by a chest radiologist and nuclear medicine physician, who assigned tumor and lymph node stages.

Findings for accurate staging were as follows:

 Primary tumorsT1 lesionsT3 lesionsLymph node staging
EUS86.7 percent86.7 percent93.3 percent75.0 percent
PET/MR imaging66.7 percent80.0 percent86.7 percent83.3 percent
CT33.3 percent46.7 percent86.7 percent66.7 percent

While the study was small and limited, “PET/MR imaging demonstrated acceptable accuracy for T staging compared with EUS and, although not statistically significant, even higher accuracy than EUS and PET/CT for prediction of N staging,” the authors wrote.