{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:08:51Z","timestamp":1789661331612,"version":"4.0.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      2-deoxy-2[\n                      <jats:sup>18<\/jats:sup>\n                      F]fluoro-D-glucose positron emission tomography-CT (FDG PET-CT) is established in staging oesophagogastric adenocarcinoma. It has an emerging role in assessing response to neoadjuvant chemotherapy (NACT) but its benefits over contrast-enhanced CT (CECT) remain unknown. This study aimed to compare the accuracy of CECT and FDG PET-CT in predicting pathological tumour (ypT) stage, nodal (ypN) stage, pathological treatment response and detecting distant metastases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Single-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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      105 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                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200966). CECT and FDG PET-CT were comparable for predicting ypT stage (AUC 0.65 vs. 0.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.76) and ypN stage (AUC 0.52 vs. 0.53,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.92). FDG PET-CT was a better predictor of pathological tumour response (AUC 0.72 vs. 0.51,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041). Eight patients had metastatic disease identified on restaging imaging; 8 (100%) by FDG PET-CT; 4 (50.0%) by CECT (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.076).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CECT 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question:<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>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?<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings:<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>CECT 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<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance:<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>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<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12797-w","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:40:40Z","timestamp":1789659640000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing the utility of FDG PET-CT and contrast-enhanced CT in patients with oesophagogastric adenocarcinoma treated with neoadjuvant chemotherapy"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9124-8006","authenticated-orcid":false,"given":"J. 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R. Davies.","order":1,"name":"Ethics","label":"Guarantor","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.","order":2,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"No complex statistical methods were necessary for this paper.","order":3,"name":"Ethics","label":"Statistics and biometry","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":4,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"This study was approved by the King\u2019s College London & Guy\u2019s and St Thomas\u2019 PET Centre Institutional Review Board on 12\/01\/2021, and the use of clinical data was approved by the Integrated Research Application System (IRAS reference: 12-NW-0511).","order":5,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Not applicable.","order":6,"name":"Ethics","label":"Study subjects or cohorts overlap","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"order":7,"name":"Ethics","label":"Methodology","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}}]}}