Comparing the utility of FDG PET-CT and contrast-enhanced CT in patients with oesophagogastric adenocarcinoma treated with neoadjuvant chemotherapy - Scorecard - MDSpire
Clinical Scorecard: Evaluating the Effectiveness of FDG PET-CT Versus Contrast-Enhanced CT in Oesophagogastric Adenocarcinoma Patients Undergoing Neoadjuvant Chemotherapy
Patients with locally advanced oesophagogastric adenocarcinoma undergoing neoadjuvant chemotherapy.
Care Setting
Oncology and Radiology departments in Western institutions.
Key Highlights
Neoadjuvant chemotherapy is standard care for oesophagogastric adenocarcinoma.
FDG PET-CT is recommended for detecting occult metastatic disease.
CECT is the most frequently used imaging technique before surgical resection.
Decreased FDG avidity predicts pathological response and survival.
There is no consensus on the optimal imaging modality for treatment response assessment.
Guideline-Based Recommendations
Diagnosis
Patients should undergo FDG PET-CT after CECT to assess for metastatic disease.
Management
Neoadjuvant chemotherapy is recommended for patients with locally advanced disease.
Monitoring & Follow-up
Post-NACT imaging with both CECT and FDG PET-CT is suggested to evaluate treatment response.
Risks
Futile surgery may occur if occult metastatic disease is not identified.
Patient & Prescribing Data
Patients with clinical tumour stage (cT) 2 or higher and metastatic lymph nodes.
Both imaging modalities are used to predict pathological response and staging.
Clinical Best Practices
Utilize both CECT and FDG PET-CT for comprehensive assessment of treatment response.
Ensure imaging is performed contemporaneously for accurate comparison.
Related Resources & Content
European Radiology, 2023 -- Assessment of Metabolic Tumor and Lymph Node Response to Neoadjuvant Chemotherapy via FDG PET-CT as Indicators of Pathological Outcomes and Survival in Oesophageal Adenocarcinoma Patients
European Radiology, 2022 -- Role of Dual-Tracer PET/CT with [68Ga]FAPI-04 and [18F]FDG in the Initial Assessment of Gastric Cancer
European Radiology, 2024 -- Assessing the Diagnostic Accuracy of [18F]ALF-NOTA-FAPI-04 PET/CT in Gastric Cancer Compared to [18F]FDG PET/CT: A Comparative Analysis
The ASCO Post, 2017 -- Early PET Imaging May Guide Treatment Decisions in Esophageal Cancer
NICE, Recommendations | Oesophago-gastric cancer: assessment and management in adults
ESMO, Clinical Practice Guideline interim update on the treatment of locally advanced oesophageal and oesophagogastric junction adenocarcinoma and metastatic squamous-cell carcinoma
Recommendations | Oesophago-gastric cancer: assessment and management in adults | Guidance | NICE
ESMO Clinical Practice Guideline interim update on the treatment of locally advanced oesophageal and oesophagogastric junction adenocarcinoma and metastatic squamous-cell carcinoma - PMC
by J. L. Moore, M. Arora, C. Sit, R. Rahman, M. Green, H. Deere, J. Lagergren, S. Chicklore, F. Chinaka, N. Maisey, S. Ngan, A. Sita-Lumsden, A. Qureshi, K. Owczarczyk, W. R. C. Knight, M. Kelly, C. R. Baker, J. A. Gossage, M. Subesinghe, A. R. Davies
