Pneumo-PET-CT: Initial Results of This Novel Technique on the Evaluation of Esophageal and Gastric Tumors with Anatomic-Surgical Correlation

Table 1

Summary of radiological findings in a TNM approaching for esophageal cancer.

TNM approaching for esophageal cancer		PNCT findings	PET findings
T (primary tumor)	Is (in situ)	Carcinoma in situ. Could be normal at pneumo-PET-CT
	1	Wall thickness (>5 mm)	Hypercaptation of FDG (it depends on the size of the tumor)
	2
	3	Ill-defined abnormal tissue around the tumor (fat planes preserved)
	4	Obliteration of fat planes with adjacent structures: 4a: the pleura, peritoneum, pericardium, or diaphragm; 4b: the aorta, carotid vessels, azygos vein, trachea left main bronchus, or vertebral body
N (lymph node involvement)	(0) Absence	Normal lymph nodes (smooth, well-defined border, uniform homogeneous attenuation, and a central fatty hilum, moderate and homogeneous enhancement, no FDG uptake)
	(1) One or two nodes	Larger than 10 mm for abdominal nodes, or larger than 5 mm for supraclavicular nodes. Morphology alterations, central necrosis, or marked or heterogeneous enhancement should also be considered	Hypercaptation of FDG (even in normal-sized nodes should be considered pathological)
	(2) Three to six nodes
	(3) Seven or more nodes
M (metastases)	(0) Absence	No metastases
	(1) Presence	Metastases. Especially on the liver (35%), the lungs (20%), bones (9%), and adrenal glands (5%)