FDG PET using SUVmax for preoperative T-staging of esophageal squamous cell carcinoma with and without neoadjuvant chemoradiotherapy

Autor: Shun Chen Huang, Yi Chun Chiu, Yu-Ming Wang, Yung Cheng Huang, Nan Tsing Chiu, Chien Chin Hsu, Hung I. Lu, Shau Hsuan Li
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Positron emission tomography
Staging
Esophageal Neoplasms
medicine.medical_treatment
Esophageal cancer
Standardized uptake value
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Fluorodeoxyglucose F18
Positron Emission Tomography Computed Tomography
Medicine
Humans
Radiology
Nuclear Medicine and imaging
Survival rate
Neoadjuvant therapy
Neoplasm Staging
Retrospective Studies
Fluorodeoxyglucose
Receiver operating characteristic
medicine.diagnostic_test
business.industry
Chemoradiotherapy
Middle Aged
medicine.disease
Prognosis
Neoadjuvant Therapy
Neoadjuvant chemoradiotherapy
Survival Rate
Treatment Outcome
ROC Curve
Radiology Nuclear Medicine and imaging
030220 oncology & carcinogenesis
Carcinoma
Squamous Cell
Female
Radiology
Esophageal Squamous Cell Carcinoma
Radiopharmaceuticals
business
medicine.drug
Research Article
Zdroj: BMC Medical Imaging
ISSN: 1471-2342
Popis: Background Accurate T-staging is pivotal for predicting prognosis and selecting appropriate therapies for esophageal squamous cell carcinoma (ESCC). The diagnostic performance of fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for its T-staging is uncertain. We investigated use of FDG PET/CT for preoperative T-staging of patients with ESCC. Methods Patients with ESCC given preoperative FDG PET/CT scans, either with (CRT[+] group) or without (CRT[−] group) neoadjuvant chemoradiotherapy, were retrospectively reviewed. Maximal standardized uptake value (SUVmax) of the primary tumors on FDG PET/CT scans were measured, and histopathological results were used as the reference standard. The associations between pathological T-stage and potential factors of age, tumor location, tumor grade, tumor size, and tumor SUVmax were analyzed. The cut-off levels of SUVmax for predicting different T-stages and for residual viable tumors after neoadjuvant chemoradiotherapy were determined using receiver operating characteristic analyses. Results We enrolled 103 patients (45 in the CRT[−] group; 58 in the CRT[+] group). SUVmax, an independent predictive factor, positively correlated with the pathological T-stage in both groups (CRT[−] group: ρ = 0.736, p 13.0) and 67.2% in the CRT[+] group (SUVmax of T0: 0–3.4, T1: 3.5–3.9, T2: 4.0–5.5, T3: 5.6–6.2, T4: > 6.2). For CRT[−] group, the accuracy using an SUVmax cut-off of 4.4 to differentiate early (T0-1) from locally advanced disease (T2-4) was 82.2% (95% CI, 71.1–93.4%). For CRT[+] group, the accuracy using an SUVmax cut-off of 3.4 to predict residual viable tumors (non-T0) after completion of chemoradiotherapy was 82.8% (95% CI, 73.0–92.5%). Conclusions The FDG avidity of a primary esophageal tumor significantly positively correlated with the pathological T-stage. PET/CT with thresholded SUVmax was useful for predicting T-stage and differentiating residual viable tumors. Electronic supplementary material The online version of this article (doi:10.1186/s12880-016-0171-7) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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