What is the preferred imaging method for pre-operative staging of esophageal cancer? PET/CT or EUS?

“EUS is done clinically almost always anyway. It has the much higher resolution and therefore defines the depth of invasion usually better than cross sectional imaging. Also, small peritumoral lymph nodes are usually better seen. The PET/CT is for other local lymph node metastases and distant metastases detection. Also at baseline the PET/CT defines the uptake which can then be compared after neo-adjuvant radio/chemotherapy. The delta between the FDG uptake pre and post therapy is predictive of the overall prognosis. ”

Dr. Patrick Veit-Haibach
Toronto, Canada

Question submitted during the the Conference on Hybrid Imaging Live 2019 regarding Dr. Veit-Haibach’s lecture on “The role of PET/CT in esophageal cancer”