Role of PET/PET CT in the staging and restaging of thoracic oesophageal cancer and gastro-oesophageal cancer: a literature review

Background: Current evidence for the use of FDG PET/PET-CT in staging thoracic oesophageal and GOJ cancer is reviewed. Methods: PubMed, Medline, Embase (1988-November 2006) and the Cochrane database identifed studies in which FDG PET and PET CT were used for the assessment of thoracic and GOJ cancer. Results: Conventional assessment remains the mainstay for evaluating the primary site. EUS is used for assessing the primary site, but when EUS is incomplete or not tolerated FDG PET CT is invaluable. The major of advantage of FDG PET CT lies in the ability to detect metastatic disease beyond the celiac axis. There is growing evidence to show that FDG PET CT is useful for assessment of treatment response. FDG PET CT will also detect other occult primary cancers. Conclusions: The contribution of FDG PET CT to the investigation of patients with primary thoracic oesophageal and GOJ cancer has resulted in improved staging, so providing the ability to optimise treatment.