| Assessment of treatment response and recurrence in esophageal carcinoma based on tumor length and standardized uptake value on positron emission tomography-computed tomography. | |
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MedLine Citation:
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PMID: 18805147 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 86 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-09-22 Completed Date: 2008-10-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1131-8 Citation Subset: AIM; IM |
Affiliation:
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Division of Abdominal and Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. johannes.roedl@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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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:
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Ann Thorac Surg. 2008 Oct;86(4):1138
[PMID:
18805148
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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