ArticleEuropean radiology2026
Comparing the utility of FDG PET-CT and contrast-enhanced CT in patients with oesophagogastric adenocarcinoma treated with neoadjuvant chemotherapy.
Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
background2-deoxy-2[ MATERIALS AND
methodsSingle-centre cohort study of patients with oesophagogastric adenocarcinoma who underwent both CECT and FDG PET-CT before and after NACT. Radiological response was evaluated using the change in oesophageal thickness on CECT and the change in SUVmax for FDG PET-CT. Receiver-operator-characteristic analysis was performed, and the area under the curve (AUC) was calculated to determine the accuracy of CECT and FDG PET-CT to predict pathological stage and treatment response.
results105 patients were identified and 92 underwent surgical resection. For inclusion, FDG PET-CT and CECT had to be performed contemporaneously (same scanner, same hospital visit) (n = 66). CECT and FDG PET-CT were comparable for predicting ypT stage (AUC 0.65 vs. 0.62, p = 0.76) and ypN stage (AUC 0.52 vs. 0.53, p = 0.92). FDG PET-CT was a better predictor of pathological tumour response (AUC 0.72 vs. 0.51, p = 0.041). Eight patients had metastatic disease identified on restaging imaging; 8 (100%) by FDG PET-CT; 4 (50.0%) by CECT (p = 0.076).
conclusionsCECT and FDG PET-CT are clinically useful for restaging following completion of NACT. FDG PET-CT was more accurate at response assessment and identified metastatic disease more frequently. The choice of imaging modality depends on balancing clinical utility with cost and accessibility. KEY POINTS: Question: Is FDG PET-CT or contrast-enhanced CT more accurate in predicting pathological stage and treatment response following completion of neoadjuvant chemotherapy in patients with oesophagogastric adenocarcinoma?
findingsCECT and FDG PET-CT were comparable for predicting pathological stage. FDG PET-CT was a better predictor of tumour response and distant metastases than CECT. CLINICAL RELEVANCE: CECT and FDG PET-CT are both useful for restaging after completion of NACT. FDG PET-CT may be most useful for patients with advanced disease where the likelihood of occult metastases is greatest and response assessment may impact clinical decision-making.
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