The Role of Qualitative and Quantitative Analysis of F18-FDG Positron Emission Tomography in Predicting Pathologic Respo
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ORIGINAL RESEARCH
The Role of Qualitative and Quantitative Analysis of F18-FDG Positron Emission Tomography in Predicting Pathologic Response Following Chemoradiotherapy in Patients with Esophageal Carcinoma Tracy Klayton & Tianyu Li & Jian Q. Yu & Lanea Keller & Jonathan Cheng & Steven J. Cohen & Neal J. Meropol & Walter Scott & Meng Xu-Welliver & Andre Konski
Published online: 10 July 2012 # Springer Science+Business Media, LLC 2012
Abstract Objective The aim of this study was to determine if a qualitative and quantitative assessment of pre- and postchemoradiotherapy (CRT) F18-FDG PET scans of esophageal cancer patients could predict for residual disease in esophagectomy specimens.
Methods We retrospectively reviewed the records of esophageal cancer patients who had undergone CRT at a single institution. Analysis was limited to esophagectomy patients with both pre- and post-CRT F18-FDG PET scans. The maximum standardized uptake value (SUV), location, and measured length of esophagus with increased F18-FDG
This paper was presented at the 51st Annual Meeting of the American Society for Radiation Oncology, November 1–5, 2009, Chicago, IL. T. Klayton : L. Keller Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
M. Xu-Welliver Department of Radiation Oncology, Ohio State University, Columbus, OH, USA
T. Li Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA, USA J. Q. Yu Department of Diagnostic Imaging, Fox Chase Cancer Center, Philadelphia, PA, USA J. Cheng : S. J. Cohen Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
A. Konski Department of Radiation Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
W. Scott Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA N. J. Meropol Division of Hematology and Oncology, University Hospitals Case Medical Center, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
A. Konski (*) Department of Radiation Oncology, Wayne State University, 4100 John R Street, Detroit, MI 48201, USA e-mail: [email protected]
J Gastrointest Canc (2012) 43:612–618
uptake were obtained from the PET scan before and 3– 4 weeks following CRT (preoperatively). The pattern of F18-FDG uptake was qualitatively assigned a category of diffuse, focal, or diffuse with focal component. Results Fifty-seven patients with localized esophageal carcinoma underwent F18-FDG PET/CT scans as part of their initial staging and post-CRT restaging workup, followed by esophagectomy. The pathologic complete response (pCR) rate was 25 %. The presence of a focal component on post-CRT PET predicted residual disease on univariate analysis (86 % vs. 64 %), and achieved significance when controlling for SUV and presence of diabetes on MVA (OR05.59, p0 0.028). There was no significant relationship between pre- or post-CRT SUV, tumor histology, or length of increased F18-FDG uptake and presence of residual disease. SUV and focality did
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