18F-fluorodeoxyglucose PET/computed tomography and risk stratification after neoadjuvant treatment in esophageal cancer patients

Context: Von Hippel-Lindau (VHL) syndrome is an inherited cancer syndrome in which patients are at risk of developing multiple tumors in different organs. 6-L-18F-fluorodihydroxyphenylalanine (18F-FDOPA) positron emission tomography (PET) is a relatively new metabolic imaging tracer proposed for the use of localizing sites of neuroendocrine tumors. There are limited data on the clinical utility of using 18F-FDOPA PET for identifying neuroendocrine tumors in a high-risk population such as VHL. Objective: The aim of this prospective study was to evaluate the clinical utility of 18F-FDOPA PET in patients with VHL-related tumors. Design: Radiological findings were prospectively collected from four imaging modalities: computed tomography, magnetic resonance imaging (MRI), 18F-fluorodeoxyglucose PET, and 18F-FDOPA PET. 18F-FDOPA PET findings were compared with those from other imaging modalities, as well as with clinical and laboratory data, and pathology findings if patients underwent an operation. Results: In 52 patients with VHL, 390 lesions were identified by computed tomography (n = 139), MRI (n = 117), 18F-fluorodeoxyglucose PET (n = 94), and 18F-FDOPA PET (n = 40). 18F-FDOPA PET identified 20 pancreatic and 20 extrapancreatic tumors, including lesions in the adrenal gland (n = 11), kidney (n = 3), liver (n = 4), lung (n = 1), and cervical paraganglioma (n = 1). These tumor sites were not seen by conventional imaging studies in 9.6% of patients and 4.4% of lesions. Seven of eight patients who had an 18F-FDOPA PET-positive lesion underwent resection, and pathology showed a neuroendocrine tumor. Four of 10 patients with positive adrenal uptake had elevated catecholamine levels, and six of 10 patients had a discrete mass on axial imaging. Conclusions: 18F-FDOPA PET is a useful complementary imaging study to detect neuroendocrine tumors in patients with VHL undergoing surveillance, especially in those suspected to have adrenal pheochromocytoma or unusual ectopic locations.

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Prognostic value of 18F-fluorodeoxyglucose PET/computed tomography metabolic parameters measured in the primary tumor and suspicious lymph nodes before neoadjuvant therapy in patients with esophageal carcinoma

Nuclear Medicine Communications ◽

10.1097/mnm.0000000000001347 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Francisco Tustumi ◽

Paulo Schiavom Duarte ◽

David Gutiérrez Albenda ◽

Flávio Roberto Takeda ◽

Rubens Antonio Aissar Sallum ◽

...

Keyword(s):

Computed Tomography ◽

Lymph Nodes ◽

Esophageal Carcinoma ◽

Neoadjuvant Therapy ◽

Primary Tumor ◽

Prognostic Value ◽

Metabolic Parameters ◽

18F Fluorodeoxyglucose ◽

Fluorodeoxyglucose Pet

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Correlation between change of FA score and postoperative recurrence in esophageal cancer patients who received neoadjuvant treatment.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.41 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 41-41

Author(s):

Satoru Matsuda ◽

Hiroya Takeuchi ◽

Kazumasa Fukuda ◽

Rieko Nakamura ◽

Tsunehiro Takahashi ◽

...

Keyword(s):

Esophageal Cancer ◽

Neoadjuvant Chemotherapy ◽

Cancer Patients ◽

Clinical Stage ◽

Univariate Analysis ◽

Neoadjuvant Treatment ◽

Postoperative Recurrence ◽

Transthoracic Esophagectomy ◽

Clinicopathological Factors ◽

Significant Difference

41 Background: We previously reported that fibrinogen and albumin score (FA score), which was consisted of plasma fibrinogen level (FNG) and serum albumin level (Alb), was shown to predict postoperative survival in esophageal cancer patients who underwent transthoracic esophagectomy. In this study, in patients who received neoadjuvant chemotherapy (NAC), change of FA score during NAC was reviewed and the correlation with recurrence free survival (RFS) was investigated. Methods: We retrospectively reviewed 125 patients who received neoadjuvant chemotherapy and underwent transthoracic esophagectomy in our institution between 2001 and 2012. FNG and Alb before (preTx) and after (preope) NAC were confirmed in 92 patients. Based on our previous reports, patients with elevated fibrinogen ( > 350 mg/dL) and decreased albumin ( < 3.8 g/dl) levels were allocated a FA score of 2, those with only one of these abnormalities were allocated a FA score of 1, and those with neither of these abnormalities were allocated a FA score of 0. Regarding change of FA score, based on the preTx and preope FA score, we classified into decrease group and increase (no change or increase) group. Patient characteristics, clinicopathological factors, preTx FA score, and preope FA score were reviewed, and correlation with RFS was investigated. Results: The number of preTx and preope FA score 0/1/2 was 39/41/12, 36/37/19. Regarding change of FA score, FA score decreased in 70 patients (76%), increased in 22 (24%). There was no significant difference in patient background and clinicopathological factors between groups. In survival univariate analysis, change of FA score (Increase group, HR 2.023, p = 0.025) were significantly correlated with RFS. In multivariate analysis, using preTx clinical stage as a covariate, FA score was shown to be an independent predict factor (Increase group, HR 2.076, p = 0.023) for RFS significantly. Conclusions: Change of FA score between before and after NAC was shown to be a predictive factor of RFS in esophageal cancer patients who received NAC. Both fibrinogen and albumin are popular indicators routinely measured in daily clinical practice, FA score may be highly validate and feasible.

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