HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Douglas J. Mathisen Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Roedl, J. B. Articles by Mueller, P. R. Search for Related Content PubMed PubMed Citation Articles by Roedl, J. B. Articles by Mueller, P. R. Related Collections Esophagus - cancer Related Article

---

Original Articles: General Thoracic

Assessment of Treatment Response and Recurrence in Esophageal Carcinoma Based on Tumor Length and Standardized Uptake Value on Positron Emission Tomography–Computed Tomography

^a Division of Abdominal and Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
^b Division of Nuclear Medicine, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
^c Department of Thoracic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

Accepted for publication May 6, 2008.

^_* Address correspondence to Dr Roedl, Department of Radiology, Fruit St 55, Boston, MA 02114 (Email: johannes.roedl{at}gmail.com).

Background: Previous studies demonstrated that a decrease of the standardized uptake value between pretreatment and posttreatment positron emission tomography (PET) scans can predict histopathologic treatment response in patients with esophageal cancer.

Methods: Forty-seven patients who underwent PET–computed tomography (CT) scans before (scan 1) and after (scan 2) neoadjuvant chemoradiotherapy and during the follow-up period after surgery (scan 3) were included in this study. It was evaluated whether decrease of metabolic tumor length between scan 1 and scan 2 can predict histopathologic response to treatment. Moreover, the value of PET-CT was compared with PET in the assessment of tumor recurrence based on a visual analysis of scan 3. Reference standards for treatment response and recurrence were histopathology results.

Results: The reduction of tumor length between before and after chemoradiotherapy scans (between scan 1 and scan 2) was a better predictor of histopathologic response and of time to recurrence than the decrease in standardized uptake value. The most accurate differentiation was achieved when using a cut-off value of 33% reduction of the initial tumor length. Using this threshold to define metabolic response, the sensitivity was 91% (19 of 21) and the specificity was 92% (24 of 26) for predicting histopathologic treatment response. Based on a visual analysis, PET-CT was more accurate than PET in the differentiation of tumor recurrence from posttreatment tissue changes. Integrated PET-CT achieved a sensitivity of 91% (48 of 53) and a specificity of 81% (30 of 37) in identifying sites of tumor recurrence, compared with 83% (44 of 53) and 65% (24 of 37) with PET.

Conclusions: Decrease of tumor length was shown to be a better predictor of treatment response and disease-free survival than decrease of standardized uptake value. Furthermore, PET-CT is more accurate in the evaluation of recurrence than PET.

Related Article

Invited Commentary

Donald E. Low
Ann. Thorac. Surg. 2008 86: 1138. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				D. E. Low Invited Commentary Ann. Thorac. Surg., October 1, 2008; 86(4): 1138 - 1138. [Full Text] [PDF]