Impact of 18F-FDG-PET/CT on the identification of regional lymph node metastases and delineation of the primary tumor in esophageal squamous cell carcinoma patients

Autor: Rickmer Braren, Benedikt Feuerecker, Lisa Marr, Marciana-Nona Duma, Stephanie E. Combs, Hendrik Dapper, Stefan Münch
Rok vydání: 2020
Předmět:
Adult
Male
medicine.medical_specialty
Esophageal Neoplasms
Diaphragmatic breathing
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Involved-field
PET-based
Fluorodeoxyglucose F18
Positron Emission Tomography Computed Tomography
Biopsy
medicine
Humans
Radiology
Nuclear Medicine and imaging
Computed tomography
Lymph node
Aged
Chemoradiation
Computed Tomography
Pet-based
Pattern Of Lymph Node Metastases
Subclinical infection
Aged
80 and over
medicine.diagnostic_test
business.industry
Middle Aged
medicine.disease
Primary tumor
ddc
Endoscopy
medicine.anatomical_structure
Pattern of lymph node metastases
Oncology
Positron emission tomography
Lymphatic Metastasis
030220 oncology & carcinogenesis
Original Article
Female
Esophageal Squamous Cell Carcinoma
Lymph Nodes
Lymph
Radiology
business
Zdroj: Strahlenther. Onkol. 196, 787-794 (2020)
Strahlentherapie Und Onkologie
ISSN: 1439-099X
0179-7158
DOI: 10.1007/s00066-020-01630-y
Popis: Purpose In patients undergoing chemoradiation for esophageal squamous cell carcinoma (ESCC), the extent of elective nodal irradiation (ENI) is still discussed controversially. This study aimed to analyze patterns of lymph node metastases and their correlation with the primary tumor using 18F‑fludeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans. Methods 102 ESCC patients with pre-treatment FDG-PET/CT scans were evaluated retrospectively. After exclusion of patients with low FDG uptake and patients without FDG-PET-positive lymph node metastases (LNM), 76 patients were included in the final analysis. All LNM were assigned to 16 pre-defined anatomical regions and classified according to their position relative to the primary tumor (above, at the same height, or below the primary tumor). In addition, the longitudinal distance to the primary tumor was measured for all LNM above or below the primary tumor. The craniocaudal extent (i.e., length) of the primary tumor was measured using FDG-PET imaging (LPET) and also based on all other available clinical and imaging data (endoscopy, computed tomography, biopsy results) except FDG-PET (LCT/EUS). Results Significantly more LNM were identified with 18F‑FDG-PET/CT (177 LNM) compared to CT alone (131 LNM, p CT/EUS (median 6 cm) and LPET (median 6 cm, p = 0.846) Conclusion 18F‑FDG-PET can help to identify subclinical lymph node metastases which are located outside of recommended radiation fields. PET-based involved-field irradiation might be the ideal compromise between small treatment volumes and decreasing the risk of undertreatment of subclinical metastatic lymph nodes and should be further evaluated.
Databáze: OpenAIRE
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