A systematic review of the literature by Goense et al [42] evaluating 486 patients across 8 studies reported a pooled sensitivity of 96% and a specificity of 78% in detecting recurrent disease. There was no statistically significant difference in the performance of FDG-PET/CT in patients who were asymptomatic or had a clinical indication for the examination. FDG-PET/MRI Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/MRI to follow asymptomatic patients after treatment. Fluoroscopy Upper GI Series There is no relevant literature to support the use of fluoroscopy upper GI series to follow asymptomatic patients after treatment. MRI Chest and Abdomen There is no relevant literature to support the use of MRI chest and abdomen to follow asymptomatic patients after treatment. Staging and Follow-up of Esophageal Cancer Radiography Chest There is no relevant literature to support the use of chest radiography to follow asymptomatic patients after treatment. Variant 4: Esophageal cancer. Posttreatment imaging. Suspected or known recurrence. CT Chest and Abdomen For the purposes of this document, CT examinations are considered as being performed with IV contrast. Sharma et al [43] studied 227 patients with suspected esophageal cancer who had suspected metastasis. All patients underwent FDG-PET/CT, whereas 109 patients also underwent contrast-enhanced CT. The authors reported a sensitivity of 96% and a specificity of 81% for FDG-PET/CT compared with a 97% sensitivity and a 21% specificity for contrast-enhanced CT. CT Chest, Abdomen, and Pelvis There are no specific studies comparing body CT scans that include the pelvis with those that do not in patients undergoing CT to evaluate for clinically suspected recurrent disease. FDG-PET/CT Skull Base to Mid-Thigh As above, Sharma et a [43] studied 227 patients with suspected esophageal cancer who had suspected metastasis.
Staging and Follow up of Esophageal Cancer. A systematic review of the literature by Goense et al [42] evaluating 486 patients across 8 studies reported a pooled sensitivity of 96% and a specificity of 78% in detecting recurrent disease. There was no statistically significant difference in the performance of FDG-PET/CT in patients who were asymptomatic or had a clinical indication for the examination. FDG-PET/MRI Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/MRI to follow asymptomatic patients after treatment. Fluoroscopy Upper GI Series There is no relevant literature to support the use of fluoroscopy upper GI series to follow asymptomatic patients after treatment. MRI Chest and Abdomen There is no relevant literature to support the use of MRI chest and abdomen to follow asymptomatic patients after treatment. Staging and Follow-up of Esophageal Cancer Radiography Chest There is no relevant literature to support the use of chest radiography to follow asymptomatic patients after treatment. Variant 4: Esophageal cancer. Posttreatment imaging. Suspected or known recurrence. CT Chest and Abdomen For the purposes of this document, CT examinations are considered as being performed with IV contrast. Sharma et al [43] studied 227 patients with suspected esophageal cancer who had suspected metastasis. All patients underwent FDG-PET/CT, whereas 109 patients also underwent contrast-enhanced CT. The authors reported a sensitivity of 96% and a specificity of 81% for FDG-PET/CT compared with a 97% sensitivity and a 21% specificity for contrast-enhanced CT. CT Chest, Abdomen, and Pelvis There are no specific studies comparing body CT scans that include the pelvis with those that do not in patients undergoing CT to evaluate for clinically suspected recurrent disease. FDG-PET/CT Skull Base to Mid-Thigh As above, Sharma et a [43] studied 227 patients with suspected esophageal cancer who had suspected metastasis.