18F-FDG PET/CT Parameters for Predicting Prognosis in Esophageal Cancer Patients Treated With Concurrent Chemoradiotherapy

Background and Aims: This study evaluated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (18F-FDG PET/CT) performed before and after concurrent chemoradiotherapy (CCRT) in esophageal cancer. Methods: We analyzed the prognosis of 50 non-metastatic squamous cell esophageal cancer (T1-4N0-2) patients who underwent CCRT with curative intent at Inje University Busan Paik Hospital and Haeundae Paik Hospital from 2009 to 2019. Median total radiation dose was 54 Gy (range 34-66 Gy). Our aim was to investigate the relationship between PET/CT values and prognosis. The primary end point was progression-free survival (PFS). Results: The median follow-up period was 9.9 months (range 1.7-85.7). Median baseline maximum standard uptake value (SUVmax) was 14.2 (range 3.2-27.7). After treatment, 29 patients (58%) showed disease progression. The 3-year PFS and overall survival (OS) were 24.2% and 54.5%, respectively. PFS was significantly lower ( P = 0.015) when SUVmax of initial PET/CT exceeded 10 (n = 22). However, OS did not reach a significant difference based on maximum SUV ( P = 0.282). Small metabolic tumor volume (≤14.1) was related with good PFS ( P = 0.002) and OS ( P = 0.001). Small total lesion of glycolysis (≤107.3) also had a significant good prognostic effect on PFS ( P = 0.009) and OS ( P = 0.025). In a subgroup analysis of 18 patients with follow-up PET/CT, the patients with SUV max ≤3.5 in follow-up PET/CT showed longer PFS ( P = 0.028) than those with a maximum SUV >3.5. Conclusion: Maximum SUV of PET/CT is useful in predicting prognosis of esophageal cancer patients treated with CCRT. Efforts to find more effective treatments for patients at high risk of progression are still warranted.

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Clinical value of FDG PET/CT in predicting local failure in patients with esophageal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15197 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15197-e15197

Author(s):

Bingjie Fan ◽

Man Hu ◽

Li Kong ◽

Xiaoli Zhang ◽

Zheng Fu ◽

...

Keyword(s):

Esophageal Cancer ◽

Local Recurrence ◽

Fdg Pet ◽

Residual Tumor ◽

Local Failure ◽

Fdg Uptake ◽

Failure Patterns ◽

Pet Ct ◽

Fdg Pet Ct

e15197 Background: Local failure, including local residual tumor and local recurrence, is the most common failure patterns for patients with esophageal cancer (EC) treated with radiotherapy. The purpose of this study was to evaluate the value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for predicting local failure in patients with EC. Methods: Twenty-two patients with biopsy-proven EC treated definitively with RT with or without chemotherapy were enrolled from June 2010 to August 2012. Dose of 60.4 - 70.2 Gy with 1.8 - 2.0Gy /fraction were delivered with three-dimensional conformal radiation therapy (CRT). All patients underwent FDG PET/CT scan prior to therapy. The patients were followed up every 3 months after treatment completion. Patients who developed local failure were confirmed with histological evidence or follow-up. Results: The follow up time was in the range of 5-30 months. Of 22 patients, 3 patients had local residual tumor, 2 patients experienced local recurrence. The mean SUVmax for patients with local failure was higher than that for patients without local failure (15.688±3.115 vs. 14.137± 4.397, p = 0.54). The local failure regions were mostly the regions with higher metabolic activity before radiotherapy. Conclusions: Patients with higher FDG-uptake may have higher risk to experienced local failure. The local failure regions were localized mostly in the higher FDG uptake regions of pre-therapeutically FGD PET/CT scans of the patients with EC.

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Prevalence of esophageal cancer during the pretreatment of hypopharyngeal cancer patients: Routinely performed esophagogastroduodenoscopy and FDG-PET/CT findings

Acta Oncologica ◽

10.3109/0284186x.2011.652260 ◽

2012 ◽

Vol 51 (5) ◽

pp. 645-652 ◽

Cited By ~ 6

Author(s):

Shuichiro Nakaminato ◽

Akira Toriihara ◽

Tomoko Makino ◽

Tatsuyuki Kawano ◽

Seiji Kishimoto ◽

...

Keyword(s):

Esophageal Cancer ◽

Cancer Patients ◽

Fdg Pet ◽

Hypopharyngeal Cancer ◽

Ct Findings ◽

Pet Ct ◽

Fdg Pet Ct

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Metabolic parameters of sequential 18F-FDG PET/CT predict overall survival of esophageal cancer patients treated with (chemo-) radiation

Radiation Oncology ◽

10.1186/s13014-019-1236-x ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Yimin Li ◽

Sebastian Zschaeck ◽

Qin Lin ◽

Sijia Chen ◽

Lili Chen ◽

...

Keyword(s):

Overall Survival ◽

Esophageal Cancer ◽

Cancer Patients ◽

Fdg Pet ◽

Metabolic Parameters ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Follow-up or Surveillance 18F-FDG PET/CT and Survival Outcome in Lung Cancer Patients

Journal of Nuclear Medicine ◽

10.2967/jnumed.113.136770 ◽

2014 ◽

Vol 55 (7) ◽

pp. 1062-1068 ◽

Cited By ~ 31

Author(s):

A. J. Antoniou ◽

C. Marcus ◽

A. K. Tahari ◽

R. L. Wahl ◽

R. M. Subramaniam

Keyword(s):

Lung Cancer ◽

Cancer Patients ◽

Fdg Pet ◽

Survival Outcome ◽

Lung Cancer Patients ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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[F18] FDG-PET/CT for manual or semiautomated GTV delineation of the primary tumor for radiation therapy planning in patients with esophageal cancer: is it useful?

Strahlentherapie und Onkologie ◽

10.1007/s00066-020-01701-0 ◽

2020 ◽

Author(s):

Franziska Walter ◽

Constanze Jell ◽

Barbara Zollner ◽

Claudia Andrae ◽

Sabine Gerum ◽

...

Keyword(s):

Esophageal Cancer ◽

Primary Tumor ◽

Fdg Pet ◽

Interobserver Variability ◽

Target Volume ◽

Standardized Uptake Values ◽

Positron Emission ◽

Pet Ct ◽

Significant Difference ◽

Fdg Pet Ct

Abstract Background Target volume definition of the primary tumor in esophageal cancer is usually based on computed tomography (CT) supported by endoscopy and/or endoscopic ultrasound and can be difficult given the low soft-tissue contrast of CT resulting in large interobserver variability. We evaluated the value of a dedicated planning [F18] FDG-Positron emission tomography/computer tomography (PET/CT) for harmonization of gross tumor volume (GTV) delineation and the feasibility of semiautomated structures for planning purposes in a large cohort. Methods Patients receiving a dedicated planning [F18] FDG-PET/CT (06/2011–03/2016) were included. GTV was delineated on CT and on PET/CT (GTVCT and GTVPET/CT, respectively) by three independent radiation oncologists. Interobserver variability was evaluated by comparison of mean GTV and mean tumor lengths, and via Sørensen–Dice coefficients (DSC) for spatial overlap. Semiautomated volumes were constructed based on PET/CT using fixed standardized uptake values (SUV) thresholds (SUV30, 35, and 40) or background- and metabolically corrected PERCIST-TLG and Schaefer algorithms, and compared to manually delineated volumes. Results 45 cases were evaluated. Mean GTVCT and GTVPET/CT were 59.2/58.0 ml, 65.4/64.1 ml, and 60.4/59.2 ml for observers A–C. No significant difference between CT- and PET/CT-based delineation was found comparing the mean volumes or lengths. Mean Dice coefficients on CT and PET/CT were 0.79/0.77, 0.81/0.78, and 0.8/0.78 for observer pairs AB, AC, and BC, respectively, with no significant differences. Mean GTV volumes delineated semiautomatically with SUV30/SUV35/SUV40/Schaefer’s and PERCIST-TLG threshold were 69.1/23.9/18.8/18.6 and 70.9 ml. The best concordance of a semiautomatically delineated structure with the manually delineated GTVCT/GTVPET/CT was observed for PERCIST-TLG. Conclusion We were not able to show that the integration of PET/CT for GTV delineation of the primary tumor resulted in reduced interobserver variability. The PERCIST-TLG algorithm seemed most promising compared to other thresholds for further evaluation of semiautomated delineation of esophageal cancer.

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