Document Detail


Assessment of treatment response and recurrence in esophageal carcinoma based on tumor length and standardized uptake value on positron emission tomography-computed tomography.
MedLine Citation:
PMID:  18805147     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Johannes B Roedl; Mukesh G Harisinghani; Rivka R Colen; Alan J Fischman; Michael A Blake; Douglas J Mathisen; Peter R Mueller
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  86     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-22     Completed Date:  2008-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1131-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Abdominal and Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. johannes.roedl@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / diagnosis*,  mortality,  pathology,  therapy*
Aged
Aged, 80 and over
Area Under Curve
Carcinoma, Squamous Cell / diagnosis*,  mortality,  therapy*
Chemotherapy, Adjuvant
Cohort Studies
Combined Modality Therapy
Esophageal Neoplasms / mortality,  radiography,  radionuclide imaging*,  therapy*
Esophagectomy / methods
Female
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Neoadjuvant Therapy / methods
Neoplasm Recurrence, Local / radiography,  radionuclide imaging*
Neoplasm Staging
Positron-Emission Tomography
Postoperative Care
Predictive Value of Tests
Preoperative Care
Proportional Hazards Models
Radiotherapy, Adjuvant
Sensitivity and Specificity
Tomography, X-Ray Computed
Treatment Outcome
Tumor Burden
Comments/Corrections
Comment In:
Ann Thorac Surg. 2008 Oct;86(4):1138   [PMID:  18805148 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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