Advantages of PET in Espophageal Cancer Still Unproven

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PETEspophageal Cancer

A new report stipulates that a patient benefits from positron emission tomography (PET) in esophageal cancer, either on its own or in conjunction with computed tomography (CT), have yet to be proven true.

Researchers from the German Institute for Quality and Efficiency in Health Care (IQWiG; Köln, Germany) explored studies that had investigated the consequences of diagnostic interventions using PET or PET/CT, taking into account whether they were accompanied by noticeable improvements for patients, such as an increased of chances of survival or improved quality of life, or were able to save them from pointless operations or further diagnostic procedures. The search for direct comparative intervention studies however was unsuccessful, which begs the question regarding the patient-relevant benefit of PET or PET/CT in esophageal cancer remains unclear and unanswered. 

The researchers also looked for studies in which the diagnostic precision and predictive value of PET or PET/CT was compared with other examination practices. They discovered 48 studies pertinent for diagnostic and predictive accuracy, of which most evaluated the accuracy of primary staging. However, 19 studies directly compared PET with CT; the end results in favor of one or the two methods could not be reached, as no statistically major difference was presented between either of them or the data could not be interpreted with absolute certainty. The report was published by IQWiG on August 20, 2013.

“A reliable conclusion on the diagnostic and prognostic accuracy of PET or PET/CT in restaging or recurrence diagnostics is therefore not possible. “In particular the potential advantage of PET and PET/CT, which visualize metabolic activity, remains unclear versus morphologic imaging techniques such as CT or magnetic resonance imaging, which display anatomical structures,” determined the researchers.

Around 4,800 men and 1,400 women are diagnosed with esophageal cancer in Germany annually. The median age of the disease’s inception is 65 years, and the 5-year survival rate is 20 percent at best.

Many experts believe that an assessment using PET or PET/CT is better able to determine how far a tumor has spread (staging) and whether it has responded to treatment (restaging); furthermore, better detection and ability of tumor reappearance should be made possible.

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