Article Figures & Data
Figures
- FIGURE 1.
Study flowchart. CCRT = concurrent chemoradiotherapy; MPR = major pathologic response.
- FIGURE 2.
(A–E) Representative 18F-FAPI PET/CT scans for 5 study participants who experienced good response to treatment. Images show that tracer uptake is significantly decreased or close to background level after nCC. (F–J) Representative 18F-FAPI PET/CT scans for 5 study participants who experienced poor response to treatment. Images show slight decreases in tracer uptake after neoadjuvant therapy. Arrows indicate foci.
- FIGURE 3.
Correlations between 18F-FAPI PET/CT parameters and TRG (Spearman coefficient) at baseline and after treatment. Red represents positive correlation between 2 variables, and blue represents negative correlation. Stronger correlations are in darker colors. *P < 0.05. **P < 0.01. ***P < 0.001.
- FIGURE 4.
Receiver operating characteristic curves for assessing predictive accuracy of SUVs on 18F-FAPI PET/CT for identifying good and poor pathologic responders to nCC among participants with LA-ESCC. SUVmax2 = SUVmax after nCC; SUVpeak2 = SUVpeak after nCC; SUVmean2 = SUVmean after nCC; TBRmax2 = ratio of SUVmax to SUVmean of blood after nCC; TBRmean2 = ratio of SUVmean to SUVmean of blood after nCC.
Tables
Characteristic All patients (n = 32) Good response group (n = 16) Poor response group (n = 16) Age at enrollment (y) Mean ± SD 64.53 ± 5.61 65.25 ± 5.34 63.81 ± 5.96 Median and range 65 (53–74) 65.5 (57–74) 63.5 (53–73) Sex Male 29 13 16 Female 3 3 0 SCC histologic type 32 16 16 Pathologic tumor staging ypT0 14 12 2 ypT1 6 4 2 ypT2 3 0 3 ypT3 8 0 8 ypT4 1 0 1 Pathologic lymph node staging ypN0 22 14 8 ypN1 9 2 7 ypN2 1 0 1 Degree of differentiation Well 3 0 3 Moderate 6 2 4 Poor 9 2 7 Not applicable 14 12 2 Tumor regression grade 0 14 12 2 1 5 4 1 2 9 0 9 3 4 0 4 Pathologic response pCR 10 10 0 Major pathologic response 6 6 0 Other 16 0 16 PD-L1 status* TPS < 1 10 1 9 TPS ≥ 1 16 12 4 Unknown 6 3 3 18F-FAPI PET/CT scans available Baseline and after 23 12 11 Only baseline 32 16 16 ↵* PD-L1 status was evaluated by TPS determined using Dako 22C3 antibody.
SCC = squamous cell carcinoma; TPS = tumor proportion score.
Data are number, except for age.
- TABLE 2.
Comparison of 18F-FAPI PET/CT Parameters at Baseline and After Neoadjuvant Therapy
Parameter Baseline After neoadjuvant therapy P SUVmax 11.81 (9.12–15.49) 5.48 ± 3.52 <0.001 SUVpeak 8.11 (5.97–11.64) 3.76 ± 2.63 <0.001 SUVmean 6.29 (4.57–8.57) 2.62 ± 2.02 <0.001 TBRmax 11.24 (10.11–14.14) 5.67 ± 3.13 <0.001 TBRmean 5.80 (5.35–7.79) 2.70 ± 1.81 <0.001 Data are median and range or mean ± SD (n = 23).
- TABLE 3.
Comparison of 18F-FAPI PET/CT Parameters at Different Time Points Between Patient Groups with Good and Poor Responses to nCC
Baseline After neoadjuvant therapy Change with treatment Parameter Good response (n = 16) Poor response (n = 16) P Good response (n = 12) Poor response (n = 11) P Good response (n = 12) Poor response (n = 11) P SUVmax 12.90 (10.88–16.05) 12.31 (9.12–15.49) 0.369 3.61 (2.23–4.75) 6.85 (4.92–8.62) 0.011 9.71 (8.35–22.88) 2.56 (−0.52–7.53) 0.009 SUVpeak 9.57 (8.08–12.08) 8.67 (5.97–11.33) 0.359 2.10 (1.54–3.04) 4.82 (3.14–5.73) 0.011 7.48 (5.86–9.79) 1.35 (−0.04–5.92) 0.009 SUVmean 6.84 (5.84–9.05) 6.92 (4.59–8.57) 0.463 1.55 (1.05–2.05) 3.12 (2.20–4.19) 0.009 5.53 (4.27–7.33) 1.55 (0.08–4.50) 0.012 TBRmax 11.97 (10.25–13.97) 13.04 (10.74–16.39) 0.492 3.95 (2.79–4.42) 6.84 (5.63–9.28) 0.001 7.63 (6.14–9.99) 3.16 (1.43–8.59) 0.035 TBRmean 6.50 (5.39–7.43) 7.26 (5.60–9.18) 0.498 1.77 (1.29–1.90) 3.18 (2.52–4.56) 0.003 4.27 (3.77–5.67) 1.91 (0.74–4.79) 0.039 TLF 146.70 (91.26–246.19) 220.03 (110.46–318.02) 0.83 — — — — — — MTV 23.95 (17.92–30.97) 34.92 (13.58–51.94) 0.391 — — — — — — Parameter AUC P Threshold Sensitivity (%) Specificity (%) 95% CI SUVmax2 0.87 0.0026 6.41 63.64 100 0.73–1.0 TBRmax2 0.86 0.0031 5.12 81.82 91.67 0.70–1.0 SUVpeak2 0.89 0.0017 3.07 81.82 83.33 0.75–1.0 SUVmean2 0.88 0.0021 2.14 81.82 83.33 0.74–1.0 TBRmean2 0.88 0.0021 2.17 81.82 91.67 0.73–1.0 ΔSUVmax 0.81 0.0116 7.91 81.82 83.33 0.63–0.99 ΔTBRmax 0.74 0.0564 4.47 63.64 91.67 0.52–0.95 ΔSUVpeak 0.82 0.0097 5.19 72.73 83.33 0.64–0.99 ΔSUVmean 0.81 0.0116 4.59 81.82 75 0.63–0.99 ΔTBRmean 0.74 0.0489 2.73 63.64 91.67 0.52–0.96 SUVmax2 = SUVmax after nCC; SUVpeak2 = SUVpeak after nCC; SUVmean2 = SUVmean after nCC; TBRmax2 = ratio of SUVmax to SUVmean of blood after nCC; TBRmean2 = ratio of SUVmean to SUVmean of blood after nCC.
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