Key Points

• Conventional scintigraphy allows for functional assessment of the esophagus and provides information that is complementary to clinical and radiologic evaluation.
• Radionuclide scintigraphy is an alternative to conventional imaging and esophageal function tests in the assessment of functional esophageal disorders.
• PET with the glucose analogue FDG is more sensitive than CT for detecting locoregional and distant metastasis in patients with esophageal cancer and is now generally accepted as an important method for staging and restaging of this disease.
• PET is most useful in detection of occult stage IV cancer and identification of local or distant metastatic sites that are most easily accessible for tissue confirmation.
• Limitations of PET in cancer detection are poor sensitivity for small volume tumors and inability to differentiate inflammation from cancer.
• The roles of PET in treatment planning, prognostication, and assessment of therapy are being defined.

Several nuclear imaging techniques are available for evaluation of esophageal disorders. These are most conveniently divided into two categories: conventional scintigraphy, predominantly used for imaging of patients with benign diseases, and positron emission tomography (PET), used for imaging of patients with esophageal cancer.