Positron emission tomography in the staging of esophageal cancer

Accurate staging of patients with esophageal cancer (EC) is essential for selection of appropriate treatment and to predict prognosis. In recent years, positron emission tomography using the positron emitting glucose analogue 18F- fluorodeoxyglucose (FDG-PET) has emerged as a particularly useful adjunct to anatomical imaging modalities as computed tomography (CT) and endoscopic ultrasonography (EUS). In the initial staging of EC the additional value of FDG-PET is its ability to identify distant metastases (stage IV disease), excluding patients from unnecessary surgery. The combination of FDG-PET and endoscopic ultrasonography with fine-needle aspiration (EUS-FNA) has been suggested as the most effective strategy for preoperative EC staging.