PD-0129: FDG-PET/CT for prediction and assessment of pathological response to induction CRT for esophageal carcinoma

2014 ◽  
Vol 111 ◽  
pp. S50
Author(s):  
P. Dirix ◽  
C. Deroose ◽  
P. Nafteux ◽  
T. Lerut ◽  
J. Coolen ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Fdg Pet ◽  
Pathological Response ◽  
Pet Ct ◽  
Fdg Pet Ct

302 IS 18F-FDG PET/CT PARAMETERS USEFUL IN PREDICTING PATHOLOGICAL RESPONSE TO NEOADJUVANT CHEMORADIOTHERAPY FOR ESOPHAGEAL CARCINOMA?

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
F Tustumi ◽  
F Takeda ◽  
P Duarte ◽  
D Albenda ◽  
R Sallum ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Neoadjuvant Therapy ◽  
Metabolic Activity ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Pathological Response ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract   The 18F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) provides an ability to functionally evaluate metabolic activity improving patient selection for surgical treatment. The value of SUVmax, MTV and TLG from FDG PET/CT of primary tumor and lymph nodes in the setting of neoadjuvant chemoradiotherapy for esophageal cancer in predicting pathological response to neoadjuvant therapy is the aim of this study. Methods A retrospective cohort study was performed, assessing the correlation of SUVmax and volumetric parameters (MTV and TLG) of 18F-FDG PET/CT prior and post to neoadjuvant therapy for esophageal carcinoma with the pathological response as outcomes. Results One hundred and seventeen patients were included. The higher AUC values in predicting pathological complete response were obtained for the primary tumor, on post neoadjuvant therapy. These variables showed high sensibility, but low specificity (SUVmax: AUC: 0.71, 95% CI: 0.55–0.87; MTV: AUC: 0.7, 95% CI: 0.54–0.86; TLG: AUC 0.71, 95% CI: 0.55–0.87). Conclusion PET-Scan functionally evaluates metabolic activity, and the absolute values and changes of SUVmax and volumetric variables provide important information for pathological tumor response to neoadjuvant chemoradiotherapy.

Bone Sequestration as a Consequence of Esophageal Carcinoma Metastasis Detected by 18F-FDG PET/CT

2018 ◽  
Vol 43 (11) ◽  
pp. 846-847
Author(s):  
Futao Cui ◽  
Minggang Su ◽  
Chunmeng Chen ◽  
Rong Tian
Keyword(s):  
Esophageal Carcinoma ◽  
Fdg Pet ◽  
Pet Ct ◽  
Carcinoma Metastasis ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals 18F-FDG PET/CT Metrics Are Correlated to the Pathological Response in Esophageal Cancer Patients Treated With Induction Chemotherapy Followed by Neoadjuvant Chemo-Radiotherapy

2020 ◽  
Vol 10 ◽  
Author(s):  
Nicola Simoni ◽  
Gabriella Rossi ◽  
Giulio Benetti ◽  
Michele Zuffante ◽  
Renato Micera ◽  
...  
Keyword(s):  
Induction Chemotherapy ◽  
Fdg Pet ◽  
Tumor Regression ◽  
Standardized Uptake Value ◽  
Pathological Response ◽  
Tumor Regression Grade ◽  
Induction Phase ◽  
Major Response ◽  
Pet Ct ◽  
Fdg Pet Ct

Background and ObjectiveThe aim of this study was to assess the ability of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) to provide functional information useful in predicting pathological response to an intensive neoadjuvant chemo-radiotherapy (nCRT) protocol for both esophageal squamous cell carcinoma (SCC) and adenocarcinoma (ADC) patients.Material and MethodsEsophageal carcinoma (EC) patients, treated in our Center between 2014 and 2018, were retrospectively reviewed. The nCRT protocol schedule consisted of an induction phase of weekly administered docetaxel, cisplatin, and 5-fluorouracil (TCF) for 3 weeks, followed by a concomitant phase of weekly TCF for 5 weeks with concurrent radiotherapy (50–50.4 Gy in 25–28 fractions). Three 18F-FDG PET/CT scans were performed: before (PET1) and after (PET2) induction chemotherapy (IC), and prior to surgery (PET3). Correlation between PET parameters [maximum and mean standardized uptake value (SUVmax and SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)], radiomic features and tumor regression grade (TGR) was investigated.ResultsFifty-four patients (35 ADC, 19 SCC; 48 cT3/4; 52 cN+) were eligible for the analysis. Pathological response to nCRT was classified as major (TRG1-2, 41/54, 75.9%) or non-response (TRG3-4, 13/54, 24.1%). A major response was statistically correlated with SCC subtype (p = 0.02) and smaller tumor length (p = 0.03). MTV and TLG measured prior to IC (PET1) were correlated to TRG1-2 response (p = 0.02 and p = 0.02, respectively). After IC (PET2), SUVmean and TLG correlated with major response (p = 0.03 and p = 0.04, respectively). No significance was detected when relative changes of metabolic parameters between PET1 and PET2 were evaluated. At textural quantitative analysis, three independent radiomic features extracted from PET1 images ([JointEnergy and InverseDifferenceNormalized of GLCM and LowGrayLevelZoneEmphasis of GLSZM) were statistically correlated with major response (p < 0.0002).Conclusions18F-FDG PET/CT traditional metrics and textural features seem to predict pathologic response (TRG) in EC patients treated with induction chemotherapy followed by neoadjuvant chemo-radiotherapy. Further investigations are necessary in order to obtain a reliable predictive model to be used in the clinical practice.

Intramural Metastasis of Esophageal Carcinoma to the Reconstructed Gastric Tube Detected by FDG PET/CT

2009 ◽  
Vol 34 (8) ◽  
pp. 523-525 ◽  
Author(s):  
Kaori Nishida ◽  
Chio Okuyama ◽  
Takao Kubota ◽  
Shigenori Matsushima ◽  
Minori Oda ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Fdg Pet ◽  
Gastric Tube ◽  
Pet Ct ◽  
Intramural Metastasis ◽  
Fdg Pet Ct

PS02.066: ROLE OF 18F-FDG-PET/CT IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA AFTER NEOADJUVANT CHEMORADIOTHERAPY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 139-139
Author(s):  
Tadahiro Hirashima ◽  
Ken Sasaki ◽  
Yasuto Uchikado ◽  
Itaru Omoto ◽  
Yusaku Osako ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Fdg Pet ◽  
Neoadjuvant Chemoradiotherapy ◽  
Pathological Response ◽  
Pet Ct ◽  
Before And After ◽  
Fdg Pet Ct

Abstract Background The aim of this study was to assess the role of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) in predicting pathological response and survival in patients with esophageal squamous cell carcinoma (ESCC) treated with neoadjuvant chemoradiotherapy (nCRT). Methods Thirty patients with advanced ESCC received nCRT followed by surgery, and underwent FDG-PET/CT twice before and after nCRT. We compared the results of FDG-PET/CT with the pathological results and prognosis. Results Pathological response was found to correlate with the maximum standardised uptake value (SUVmax) after nCRT and the rate of decrease of SUVmax. Using univariate analysis, pN, SUVmax after nCRT and the rate of decrease of SUVmax were found to be prognostic factors. Multivariate analysis revealed that only pN was an independent prognostic factor Conclusion The prediction of pathological response and prognosis using FDG-PET/CT is not as reliable as pathological detection of lymph node metastasis, but could be a useful method contributing to treatment decisions. Neoadjuvant chemoradiotherapy (nCRT) plus surgery has been shown to improve survival rates and should be regarded as a standard of care for patients with locally advanced esophageal squamous cell carcinoma (ESCC). Appropriate evaluation of nCRT efficacy based on noninvasive parameters might help in individualizing treatments for patients with ESCC. 18F-fluorodeoxyglucose positronemission tomography/computed tomography (FDG-PET/CT) reflects tumor cell viability based on enhanced FDG uptake as a result of increased glucose metabolism. FDG-PET/CT is useful for the staging of advanced ESCC before treatment, and for evaluating the response to nCRT; however, findings from currently available studies in this regard are controversial. In the present study, we examined the role and usefulness of FDG-PET/CT in decisions regarding staging, prediction of histopathological response, and overall survival in patients with advanced ESCC treated with nCRT; this was achieved by analyzing the maximum standardized uptake value (SUVmax) before and after treatment, and the rate of decrease of SUVmax. Disclosure All authors have declared no conflicts of interest.

Comparison of gross tumor volume delineated by anatomic imaging and FDG PET/CT for esophageal carcinoma and validation with pathological specimen

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15090-15090
Author(s):  
J. M. Yu ◽  
X. J. Zhong ◽  
B. J. Zhang ◽  
D. B. Mu ◽  
A. Q. Han ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Ct Scan ◽  
Fdg Pet ◽  
Gross Tumor Volume ◽  
Tumor Volume ◽  
Pet Scan ◽  
Pathologic Examination ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

15090 Background: Although results of clinical studies have demonstrated FDG PET/CT improved target volume delineation in various tumors, only few studies compared delineation based on PET/CT with pathologic examination. Aim of our study was to compare anatomic imaging modalities including computed tomography (CT), esophagram, endoscopy with FDG PET/CT for delineation of gross tumor volume (GTV) in esophageal carcinoma and to validate the results with the pathologic examination. Methods: Thirty patients with stages II-III squamous cell carcinoma underwent transthoracic esophagectomy were enrolled. PET/CT, esophagram and endoscopy were performed with patients before operations. The length of the lesion on the PET/CT scan and on the CT portion of the PET/CT and the PET scan alone was determined independently by 3 separate investigative groups. PET/CT scan was evaluated by visual inspection for abnormality. A standard uptake value (SUV) of 2.5 was used in the PET scan to delineate the tumor extent. The lengths of GTVs determined with the five modalities (PET/CT, PET, CT, esophagram and endoscopy) were compared quantitatively and validated with the pathologic specimen. The sizes of the tumors were measured by pathologic examination which was considered as the gold standard. Results: Of the 30 patients, 9 had T2 tumors, 20 had T3 tumors and 1 had T4 tumor with an involvement of pleura. Three tumors were located at the upper esophagus, 14 at the middle esophagus, 13 at the lower esophagus. The mean length of the carcinoma was 5.85cm(SD 2.50cm) measured by pathologic examination, 5.79cm (SD 2.04cm) as determined by PET scan, 5.14cm (SD 1.65cm) by PET/CT scan, 5.42 cm(SD 2.42cm)by CT scan, 5.50cm(SD 2.79cm) by endoscopy, and 6.07cm(SD 2.75cm) by esophagram respectively. Although the lengths of the tumors as measured by the five imaging modalities were no significant difference, the result of PET was the most accurate. Conclusions: Compared with tumor lengths measured by pathologic examination, PET with a SUV 2.5 was found to be the most accurate modality and can help the radiation oncologist delineate the GTV of esophageal carcinoma precisely. No significant financial relationships to disclose.

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