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PET Scanning Valuable for Staging of Esophageal Cancer

According to a recent article published in the Journal of Clinical Oncology, it appears that positron emission tomography (PET) scans may be valuable to determine the stage of patients diagnosed with esophageal cancer, particularly those with cancer that has spread from its site of origin to distant sites in the body.

The accurate determination of the extent of spread, or the stage, of esophageal cancer is imperative as the stage dictates treatment options. Types of scans, such as computer tomography (CT) scans, or procedures such as ultrasound, may be used to determine how far cancer has spread in a person or to what areas of the body the cancer has spread. However, often these procedures are not able to detect some areas of cancer spread, leaving patients with suboptimal therapeutic choices for their true stage of cancer. Since long-term survival for esophageal cancer remains poor, researchers continue to compare screening procedures to ensure patients are receiving the most accurate screening methods to determine their stage of cancer.

Researchers from the Netherlands recently reviewed the results of 12 studies including PET scans for the staging of esophageal cancer. PET scans utilize a combination of sugar and a radioactive isotope (molecule that spontaneously and continuously emits radiation for a specified period of time) to detect cancer cells in the body. The mixture is injected into a patient’s vein and tends to accumulate in cancer cells, rather than normal cells, as cancer cells have a higher rate of metabolism. The radioactivity is then picked up on a screen, indicating the presence of cancer cells. Results from the 12 studies indicated that PET scans can detect cancer that has spread to local or nearby tissues in over 50% of patients and can detect cancer that has spread to distant sites in the body in nearly 70% of patients. Nearly all of the suspicious areas found on PET scans were cancerous, which means that this type of scan may be useful for directing treatment options.

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The researchers concluded that PET scanning may be a valuable tool in helping to stage patients with esophageal cancer, particularly in ruling out cancer that has spread to distant sites in the body. However, they caution that further large trials are necessary to determine the clinical utility of PET scans and relationships to changes in the way treatment may be conducted based on PET results. Patients diagnosed with esophageal cancer may wish to speak with their physician about the risks and benefits of PET scans or the participation in a clinical trial evaluating other novel screening approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute ( and Personalized clinical trial searches are also performed on behalf of patients by

Reference: Van Westreenen HL, Westerterp M, Bossuyt PMM, et al. Systematic review of the staging performance of 18F-Fluorodeoxyglucose Positron Emission Tomography in Esophageal Cancer. Journal of Clinical Oncology. 2004;22:3805-3812.