Purpose: This work evaluates positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) in assessing response to therapy in patients with esophageal cancer.
Procedures: Twenty-four patients underwent FDG-PET before (pre-Rx) and after (post-Rx) chemoradiation therapy; 20 then underwent esophagectomy. The response of the primary tumors was visually assessed, and tumor volume, peak tumor standardized uptake value (SUV(peak)), average SUV (SUV(ave)), and total lesion glycolysis were determined pre-treatment and post-treatment. Patients were divided into groups according to the absence (Group A) or presence (Group B) of residual tumor after neoadjuvant therapy.
Results: Among the quantitative PET parameters for Group A (n = 6) and Group B (n = 18), only change in tumor volume identified complete responders. Quantitative PET indices were not different in patients with or without post-Rx esophagitis.
Conclusions: The change in tumor volume identifies patients with complete response to neoadjuvant therapy, and quantitative evaluation of the primary tumor cannot separate post-Rx inflammation from residual tumor.