대한핵의학회지 (1967년~2009년)
대한핵의학회지 2004;38(4)282~287
양전자단층촬영술을 이용한 식도암의 병기 결정 성적
(Improved Clinical Staging of Esophageal Cancer with FDG-PET)
Author 김영환,최준영,이경수1,최용수2,이은정,정현우,이수진,이경한,심영목2,김병태,
Young Hwan Kim, M.D., Joon Young Choi, M.D., Kyung Soo Lee1, M.D., Yong Soo Choi2, M.D.,Eun Jeong Lee, M.D., Hyun Woo Chung, M.D., Su Jin Lee, M.D., Kyung-Han Lee M.D.,Young Mog Shim2, M.D., and Byung-Tae Kim, M.D.
Affiliation 성균관대학교 의과대학 삼성서울병원 핵의학과, 진단방사선과1, 흉부외과2
Departments of Nuclear Medicine, Radiology1 and Thoracic Surgery2, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
Abstract

Purpose: Since preoperative staging in esophageal cancer is important in both therapy and prognosis, there had been many efforts to improve its accuracy. Recent studies indicate that whole body FDG-PET has high sensitivity in detection of metastasis in esophageal cancer. Therefore, we added FDG-PET to other conventional methods in staging esophageal cancer to evaluate the usefulness of this method. Materials & Methods: Subjects were 142 esophageal cancer patients (average 62.3¡¾8.3 yrs) who received CT and PET just before operation. First, we compared N stage and M stage of the CT or PET with those of the post-operative results. Then we compared the stage according to the EUS (T stage) and CT (N and M stage) or EUS (T stage) and CT & PET (N and M stage) to that according to the post-operative results. Results: Among 142 patients, surgical staging of 69 were N0 and 73 were N1. In M staging, 128 were M0 and 14 were M1. Sensitivity, specificity, and accuracy of N staging were 35.6%, 89.9%, 62.0% with CT and 58.9%, 71.0%, 64.7% with PET, respectively. In M staging, 14.3%, 96.9%, 88.7% with CT and 50.0%, 94.5%, 90.1% with PET, respectively. The concordances of [EUS+CT] and [EUS+CT+PET] with post-operative results were 41.2% and 54.6%, respectively and there was significant improvement of staging with additional PET scan (p<0.005). Conclusion: The concordance of [EUS+CT+PET] with post-operative result was significantly increased compared to that of [EUS+CT]. Thus, the addition of FDG-PET with other conventional methods may enable more accurate preoperative staging. (Korean J Nucl Med 38(4):282-287, 2004)

Keyword PET, Esophagus, Carcinoma.
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