| Diagnostic and prognostic value of 18F-FDG PET/CT for patients with suspected recurrence from squamous cell carcinoma of the esophagus. | |
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MedLine Citation:
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PMID: 17631554 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Patients with esophageal squamous cell carcinoma (ESCC) are commonly at high risk of recurrence within 2 y after initial treatment. The aim of this study was to evaluate the role of 18F-FDG PET/CT in patients with possibly recurrent ESCC who underwent definitive treatment. METHODS: Fifty-six patients with previously treated ESCC underwent PET/CT scans. The PET/CT findings were validated by histopathology or clinical follow-up of at least 6 mo. The sensitivity, specificity, and accuracy of PET/CT for detecting recurrence were calculated. Comparison of the standardized uptake value (SUV) was performed between patients grouped according to their status at the last follow-up (relapsed or relapse-free, alive or dead). The overall survival rates were estimated by the Kaplan-Meier method. The Cox proportional hazards model was used to evaluate independent prognostic variables for both univariate and multivariate survival analysis. RESULTS: Forty-five (80.4%) patients had recurrence in 72 (66.1%) malignant sites. On PET/CT, there were 9 false-positive and 5 false-negative results. The overall sensitivity, specificity, and accuracy of PET/CT for detecting recurrence at all sites were 93.1% (67/72), 75.7% (28/37), and 87.2% (95/109), respectively. PET/CT was highly sensitive, specific, and accurate at regional and distant sites. At local sites, sensitivity was high, but specificity was lower (50%) because of a high incidence of false-positive findings. Patients who were confirmed with recurrence or who had died at the last follow-up had higher SUVs (P = 0.027 and <0.001, respectively). In multivariate survival analysis, therapeutic modality (hazard ratio = 0.437; P = 0.044), SUV (hazard ratio = 1.071; P = 0.029), and disease status on PET/CT (hazard ratio = 2.430; P = 0.045) were independent significant prognostic predictors for overall survival. The Kaplan-Meier survival curves indicated poor prognostic outcome in subgroup patients with higher SUVs or systemic disease on PET/CT. CONCLUSION: 18F-FDG PET/CT is highly effective for detecting recurrent ESCC. The relatively low specificity at local sites is associated primarily with a high rate of false-positive interpretations at anastomoses. PET/CT can also provide noninvasive and independent prognostic information using SUV and recurrent disease pattern on PET/CT images for previously treated ESCC. |
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Authors:
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Hongbo Guo; Hui Zhu; Yan Xi; Baijiang Zhang; Ling Li; Yong Huang; Jiandong Zhang; Zheng Fu; Guoren Yang; Shuanghu Yuan; Jinming Yu |
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Publication Detail:
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Type: Journal Article Date: 2007-07-13 |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 48 ISSN: 0161-5505 ISO Abbreviation: J. Nucl. Med. Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-08-03 Completed Date: 2007-09-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 1251-8 Citation Subset: IM |
Affiliation:
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Department of Thoracic Surgery, Shandong Cancer Hospital and Institute, Jinan, Shandong Province, China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Carcinoma, Squamous Cell / diagnosis*, mortality Esophageal Neoplasms / diagnosis*, mortality Female Fluorodeoxyglucose F18 / diagnostic use* Humans Male Middle Aged Neoplasm Recurrence, Local / diagnosis* Positron-Emission Tomography / methods* Prognosis Sensitivity and Specificity Tomography, X-Ray Computed / methods* |
| Chemical | |
Reg. No./Substance:
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63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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