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 tumors
T1 lesions
T3 lesions
Lymph node staging
86.7 percent
86.7 percent
93.3 percent
75.0 percent
PET/MR imaging
66.7 percent
80.0 percent
86.7 percent
83.3 percent
33.3 percent
46.7 percent
86.7 percent
66.7 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.

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