PO-1779 Endoscopically Determined Gross Tumor Volume and Metabolic Tumor Volume in Esophageal Cancer

Abstract Purpose To investigate the interobserver variability (IOV) in target volume delineation of definitive radiotherapy for thoracic esophageal cancer (TEC) among cancer centers in China, and ultimately improve contouring consistency as much as possible to lay the foundation for multi-center prospective studies. Methods Sixteen cancer centers throughout China participated in this study. In Phase 1, three suitable cases with upper, middle, and lower TEC were chosen, and participants were asked to contour a group of gross tumor volume (GTV-T), nodal gross tumor volume (GTV-N) and clinical target volume (CTV) for each case based on their routine experience. In Phase 2, the same clinicians were instructed to follow a contouring protocol to re-contour another group of target volume. The variation of the target volume was analyzed and quantified using dice similarity coefficient (DSC). Results Sixteen clinicians provided routine volumes, whereas ten provided both routine and protocol volumes for each case. The IOV of routine GTV-N was the most striking in all cases, with the smallest DSC of 0.37 (95% CI 0.32–0.42), followed by CTV, whereas GTV-T showed high consistency. After following the protocol, the smallest DSC of GTV-N was improved to 0.64 (95% CI 0.45–0.83, P = 0.005) but the DSC of GTV-T and CTV remained constant in most cases. Conclusion Variability in target volume delineation was observed, but it could be significantly reduced and controlled using mandatory interventions.

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Comparison of patient-specific internal gross tumor volume for radiation treatment of primary esophageal cancer based separately on three-dimensional and four-dimensional computed tomography images

Diseases of the Esophagus ◽

10.1111/dote.12089 ◽

2013 ◽

Vol 27 (4) ◽

pp. 348-354 ◽

Cited By ~ 9

Author(s):

W. Wang ◽

J. Li ◽

Y. Zhang ◽

F. Li ◽

M. Xu ◽

...

Keyword(s):

Computed Tomography ◽

Esophageal Cancer ◽

Gross Tumor Volume ◽

Tumor Volume ◽

Radiation Treatment ◽

Three Dimensional ◽

Patient Specific ◽

Computed Tomography Images

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Primary Gross Tumor Volume is an Important Prognostic Factor in Locally Advanced Esophageal Cancer Patients Treated with Trimodality Therapy

Journal of Gastrointestinal Cancer ◽

10.1007/s12029-015-9699-y ◽

2015 ◽

Vol 46 (2) ◽

pp. 131-137 ◽

Cited By ~ 14

Author(s):

Drexell Hunter Boggs ◽

Andrew Hanna ◽

Whitney Burrows ◽

Naomi Horiba ◽

Mohan Suntharalingam

Keyword(s):

Esophageal Cancer ◽

Prognostic Factor ◽

Cancer Patients ◽

Gross Tumor Volume ◽

Tumor Volume ◽

Locally Advanced ◽

Advanced Esophageal Cancer ◽

Trimodality Therapy ◽

Important Prognostic Factor ◽

Locally Advanced Esophageal Cancer

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The correlation between the metabolic tumor volume and hematological parameters in patients with esophageal cancer

Annals of Nuclear Medicine ◽

10.1007/s12149-015-1020-4 ◽

2015 ◽

Vol 29 (10) ◽

pp. 906-910 ◽

Cited By ~ 6

Author(s):

Erdem Sürücü ◽

Yusuf Demir ◽

Tarık Şengöz

Keyword(s):

Esophageal Cancer ◽

Tumor Volume ◽

Hematological Parameters ◽

Metabolic Tumor Volume

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Prognostic value of 18F-FDG PET/CT metabolic tumor volume for complete pathologic response and clinical outcomes after neoadjuvant chemoradiation therapy for locally advanced esophageal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.150 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 150-150

Author(s):

Puja Venkat ◽

Jasmine A Oliver ◽

Will Jin ◽

Joshua Dault ◽

Jessica M. Frakes ◽

...

Keyword(s):

Esophageal Cancer ◽

Prognostic Value ◽

Tumor Volume ◽

Locally Advanced ◽

Standardized Uptake Value ◽

Metabolic Tumor Volume ◽

Neoadjuvant Chemoradiation ◽

Advanced Esophageal Cancer ◽

Pet Ct ◽

Locally Advanced Esophageal Cancer

150 Background: The prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has not yet been defined in locally advanced esophageal cancer (LAEC). This study aims to elucidate the prognostic role of PET/CT for patients treated with neoadjuvant chemoradiation (CRT) followed by esophagectomy. Methods: We retrospectively evaluated patients with LAEC treated from 2006 to 2014 with neoadjuvant CRT followed by esophagectomy. 86 patients had pre-CRT and post CRT PET/CT scans performed at our institution. These scans were imported into an image analysis program. PET parameters maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), mean standardized uptake value (SUVmean), and peak standardized uptake value (SUVpeak) were recorded for both pre-CRT and post-CRT scans. MTV was defined using a previously described liver method. The correlation of these parameters with pathologic complete response (pCR) and clinical outcomes was analyzed using binomial logistic regression and cox regression. Results: Pre-CRT MTV < 33.6 (median value) was significantly predictive of pCR (p = 0.019, OR = 3.064). An ROC curve was produced to determine a binary cutoff of 35.8, yielding a higher specificity (62.3% vs. 59%) and the same sensitivity (72.7%), increasing the significance to p = 0.010, OR = 3.378. The ratio of postMTV/preMTV (MTVr) was calculated. MTVr > 0.2857 (median value) was significantly predictive of distant metastasis (DM) after esophagectomy (p = 0.018, OR = 3.680). An ROC curve was produced to determine a binary cutoff of 0.301, which increased specificity from 57.1% to 60.3%, and maintained the same sensitivity at 81.3%, increasing the significance to p = 0.014, OR = 3.815. SUVmax, mean and peak were not predictive. Conclusions: Pre CRT MTV was predictive of pCR and MTVr was predictive of DM. Our data suggests that MTV is superior to SUVmax, mean and peak in predicting for response to treatment in LAEC. Further study is needed to determine if Pre CRT MTV and change in MTV can help define which patients will most benefit from esophagectomy and/ or adjuvant chemotherapy.

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