Positron emission tomography-computed tomography in predicting locoregional invasion in esophageal squamous cell carcinoma.

Division of Thoracic Surgery, Department of Surgery, Taipei-Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan.
The Annals of thoracic surgery (Impact Factor: 3.45). 06/2009; 87(5):1564-8. DOI: 10.1016/j.athoracsur.2009.02.065
Source: PubMed

ABSTRACT In order to clarify the role of positron emission tomography-computed tomography (PET/CT) in thoracic esophageal squamous cell carcinoma we investigated its value in predicting locoregional invasion.
Forty-five patients receiving curative esophagectomy and lymph node dissection were included. The relationship between PET/CT findings and pathology results were studied. Correlation between nodal uptake and the modified lymph node staging, which is based on number of involved nodes (N0 = no nodes; N1 = 1 to 3 nodes; N2 = more than 3 nodes), was evaluated.
The mean maximal standardized uptake value (SUV(max)) was 5.09 +/- 4.00 in T1, 14.17 +/- 2.46 in T2, 13.32 +/- 3.96 in T3, and 10.37 +/- 1.94 in T4 primary tumor. The SUV(max) was significantly lower in stage T1 tumors than in stage T2 and T3 tumors. For regional nodal involvement, PET/CT findings significantly correlated with pathology results. However, the sensitivity, specificity, and accuracy of PET/CT were only 57.1%, 83.3%, and 71.1%, respectively, and even lower for detecting nonregional lymph node metastasis. When stratified by the modified staging system, the mean SUV(max) was 0.64 +/- 1.60 in N0, 1.43 +/- 2.08 in N1, and 4.67 +/- 4.32 in N2 regional lymph node metastases, and was significantly higher in patients with N2 metastasis than in patients with N0 and N1 metastases.
Locoregional invasion in esophageal cancer can be predicted by PET/CT. The SUV(max) of the primary tumor helped identify T1 tumor, and the SUV(max) of the regional lymph nodes correlated with the severity of nodal involvement.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Pacific Bell began using vendor report cards as a means to provide performance feedback in 1990. One of the elements of the report card specifically measures the vendor's responsiveness to escalated problems. This item is called trouble resolution. AT&T's first grade in this area for one of its products, the 5ESS Switch, from Pacific Bell reflected poor performance, which prompted a joint effort between AT&T Customer Technical Support and the Pacific Bell Electronic Switching Assistance Center to understand and improve the performance and the grade. This joint effort spanned the period between September 1, 1990, and February 1, 1991, and was referred to as the Pacific Project. The authors describe the Pacific Project, the subsequent results, and the process changes
    Clinical Oncology - CLIN ONCOL-UK. 01/1992;
  • [Show abstract] [Hide abstract]
    ABSTRACT: To analyze the association between pretreatment 18-F-fluoro-deoxyglucose (FDG) uptake and characteristics of aggressive tumor biology in predicting outcome in esophageal cancer (EC).
    Annals of Surgical Oncology 06/2014; · 3.94 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: In this study, we aimed to explore prognostic importance of definition of preoperative metabolic tumor volume in esophageal cancer patients. Methods: 22 patients who have histologically proven stage IIA-III esophageal cancer and underwent (18)F-FDG PET/CT for preoperative staging of disease were included to the study. After (18)F-FDG PET/CT, all the patients underwent surgery within 4 weeks period. Patients have been followed up until death or Sept 15(th), 2012. Dates of death were recorded for survival analysis. During evaluation of (18)F-FDG PET/CT images, metabolic tumor volumes were calculated by drawing the isocontour region of interests from all visually positive FGD uptake lesions. Results: 22 patients (15M, 7F; mean age: 65.1±8.4, min-max:48-80) underwent (18)F-FDG PET/CT for preoperative staging of esophageal cancer. Preoperative diagnosis was squamous cell and adeno cancer in 17 (%77) and 5 (%23) patients, respectively. Location of primary tumor is distal, proximal and mid-esophagus in 13 (%59), 6 (%27) and 3 (%13) patients, respectively. Primary tumor of all the patients were FDG avid (mean SUVmax: 18.85±7.0; range: 5.5-35.1). Additionally, (18)F-FDG uptake was seen in mediastinal lymph nodes in 13 patients (5.45±8.15; range: 2.6-29.9). Mean metabolic tumor volumes of primary esophageal lesions were calculated as 8.77±8.46cm(3) (range: 2.3-34.2). Mean MTV of lymph nodes was 2.44±1.01cm(3) (range: 0.4-3.6). Mean total metabolic tumor volume was calculated as 9.99±8.58cm(3) (range: 2.3-27.3). 10 patients died during 447±121 days follow-up period. Mean survival time was 11.9±1.5 months (95%CI: 8.99-14.74) for entire patient group. Total metabolic tumor volume had a significant effect on survival (p=0.045) according to Cox proportional hazards regression analysis. One unit increase in MTV caused 1.1 (95%CI:1.003-1.196) fold increase in hazard, at any time. Conclusion: Definition of preoperative metabolic tumor volume has a prognostic value in the prediction of postoperative survival times. Patients who have higher preoperative metabolic tumor volumes could be good candidates for more aggressive chemo-radiation therapy regiments. Conflict of interest:None declared.
    Molecular imaging and radionuclide therapy. 02/2014; 23(1):12-5.