Contribution of PET-CT in radiotherapy planning of oesophageal carcinoma: A review

Purpose: The aim of this study was to systematically review published data on the efficacy of positron emission tomography-computed tomography (PET-CT) in the radiotherapy planning process of patients with oesophageal carcinoma. Methods: A systematic search of the PubMed, CINAHL, Cochrane Library and ScienceDirect databases was performed. The quality of the included studies was appraised using validated assessment tool. Data of the studies were synthesized, compared and evaluated by constructing evidentiary tables. Results: The 37 included studies, comprising a total sample size of 1921 patients, had moderate methodological quality. Overall primary tumour detection rate was 92.7%, and pooling estimate of specificity was 88% (95%CI: 83-91%) for local lymph node metastasis. The pooled studies presented heterogeneity for sensitivity (. p<0.01). The introduction of PET-CT to the radiotherapy planning process has facilitated target volume delineation. A standardized uptake value (SUV) of 2.5 could be used in supplementation to visual assessment by a qualified practitioner. Conclusions: PET-CT has a high specificity but due to its variable sensitivity, information from other clinical investigations should still be sought. Discretion and sound clinical judgment must also be exercised before using the biologic information for radiotherapy planning.