Reporting Oesophageal Cancer

Oesophageal cancer is the 14th most common cancer in the UK, with over 9,300 new cases per year. Incidence has increased by 43% since the 1970s and is higher in men than women (Cancer Research, UK).

PET-CT Scans Performed 2022-2023

At our institution, oesophageal cancer accounts for 5% of all PET-CT scans performed.

The evidence-based indications for use of PET-CT in the UK 2016 list two indications for FDG PET-CT in oesophageal cancer:

1. Staging/re-staging of patients with oesophageal or oesophago-gastric carcinoma, suitable for radical treatment including those who have received neo-adjuvant treatment
2. Evaluation of suspected recurrence of oesophago-gastric tumours when other imaging is negative or equivocal

The use of PET-CT in these indications will be studied in detail in this course, which is comprised of four modules, followed by a case-based assessment.

• Tutorial 1: Anatomy, tracer distribution and the rationale for imaging
• Tutorial 2: Primary tumour assessments (‘T’ staging)
• Tutorial 3: Nodal and metastatic disease assessment (‘N’ & ‘M’ staging)
• Tutorial 4: Recurrence, response assessment and other utilities

Learning Objectives

• Describe the radiological anatomy of the oesophagus and normal gastroesophageal distribution of FDG
• List the criteria for T Staging and the strengths and limitations of FDG PET-CT in T Staging of oesophageal tumours
• List the criteria for N and M Staging and the strengths and limitations of FDG PET-CT in N and M Staging of oesophageal tumours
• Discuss the rationale for using PET-CT to assess recurrent disease and it’s potential utility in response assessment and radiotherapy planning

Please note: To mark this course as complete on your Learning Dashboard and access your certificate of completion, you must finish all learning modules and submit the course evaluation.

Suitable for radiologists and nuclear medicine physicians who intend to train to report PET-CT, or who otherwise encounter these studies in their practice and wish to increase their confidence, for example in the role of a presenting radiologist at an MDT (Multi-Disciplinary Team).

References:

1. Evidence-based indications for the use of PET-CT in the United Kingdom 2022
2. Cancer Research UK. Accessed November 2023.