PET/CT in esophageal cancerAdenocarcinomas of the esophagus: Response to chemoradiotherapy is associated with decrease of metabolic tumor volume as measured on PET–CT: Comparison to histopathologic and clinical response evaluation
Section snippets
Patients
Fifty-one patients with adenocarcinomas of the esophagus who had undergone PET–CT scans before and after neoadjuvant chemoradiotherapy were included in this study. Tumor grade and tumor type of all malignant esophageal lesions were determined by histological examination. The histopathology after neoadjuvant chemoradiotherapy was the reference standard for assessing treatment response. Histopathologic response was defined as <10% viable cells in the postsurgical tumor specimen as used in
Association between histopathologic response and metabolic tumor volume
All pre- and post-treatment tumor volumes were measurable with the above-mentioned technique of tumor delineation both on PET and on PET–CT images. Table 2 demonstrates the association between the decrease of tumor volume parameters (maximum SUV, volume, SUV of volume, and TLG) and the histopathologic response to chemoradiotherapy. The decrease was calculated as the relative difference (in %) in tumor volume parameters between the pre-treatment and the post-treatment PET–CT scans. Table 2 shows
Discussion
Although neoadjuvant chemoradiotherapy for esophageal cancer has been studied for more than 25 years, its usefulness has remained controversial [1], [2], [3], [4], [5], [6]. However, based on the recent publications of randomized controlled trials, neoadjuvant chemoradiotherapy has become the standard choice for the treatment of locally advanced carcinomas of the esophagus [1], [2].
Unfortunately until today, no reliable methods for response prediction to chemoradiotherapy exist for esophageal
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Prognostic value of PERCIST and PET/CT metabolic parameters in patients with esophageal cancer after neoadjuvant treatment
2022, Revista Espanola de Medicina Nuclear e Imagen MolecularCirculating Tumor DNA Analysis for Detection of Minimal Residual Disease After Chemoradiotherapy for Localized Esophageal Cancer
2020, GastroenterologyCitation Excerpt :Given the observation that ctDNA analysis appeared to be more sensitive for prediction of future distant metastasis than local recurrence, we hypothesized that integration of ctDNA with an imaging biomarker capable of detecting residual local disease would further improve performance. Prior studies have suggested that changes in fluorodeoxyglucose uptake on PET-CT after treatment for localized ESCA are associated with response to therapy and survival.32–34 In an exploratory analysis, we identified a cutpoint for total lesion glycolysis (TLG) that optimally stratified patients who experienced recurrence from those who did not.
The clinical value of PERCIST to predict tumour response and prognosis of patients with oesophageal cancer treated by neoadjuvant chemoradiotherapy
2020, Clinical RadiologyCitation Excerpt :The use of SUL reduces dependence on patient weight as compared to the standard body weight normalised SUV and SULpeak reduces potential inconsistencies of single pixel measurements due to noise.28 The usefulness of 18F-FDG-volumetric parameters such as MTV and TLG for predicting treatment response also have been investigated in patients with various types of cancer including oesophageal cancer.29,30 To the authors' knowledge, a few studies have evaluated pathological response to NACRT using SUV parameters, volumetric parameters or PERCIST in oesophageal cancer patients.14,31,32
Intratreatment Response Assessment With 18F-FDG PET: Correlation of Semiquantitative PET Features With Pathologic Response of Esophageal Cancer to Neoadjuvant Chemoradiotherapy
2018, International Journal of Radiation Oncology Biology PhysicsCitation Excerpt :In our analysis, volumetric PET parameters (which extracted volume and SUV data from the entire hypermetabolic tumor) were more accurate than intensity PET parameters, which extracted data from only the most metabolically active region. Other studies, mostly using posttreatment PET scans, have similarly reported that volumetric PET parameters are better correlated to histopathologic response than are conventional SUV features such as SUV max (9, 21-23). A significant independent association with pretreatment volumetric PET parameters (MTV) and survival has also been demonstrated (24, 25).