OPEN IN READ APP
JOURNAL ARTICLE

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

Yung-Cheng Huang, Hung-I Lu, Shun-Chen Huang, Chien-Chin Hsu, Nan-Tsing Chiu, Yu-Ming Wang, Yi-Chun Chiu, Shau-Hsuan Li
BMC Medical Imaging 2017 January 5, 17 (1): 1
28056868

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 < 0.001; and CRT[+] group: ρ = 0.792, p < 0.001). The overall accuracy of the PET/CT with thresholded SUVmax for predicting the pathological T-stage was 73.3% in the CRT[-] group (SUVmax of T0: 0-1.9, T1: 2.0-4.4, T2: 4.5-6.5, T3: 6.6-13.0, T4: >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.

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read
28056868
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"