Prognostic value of 18F-fluorodeoxyglucose PET/computed tomography metabolic parameters measured in the primary tumor and suspicious lymph nodes before neoadjuvant therapy in patients with esophageal carcinoma

Abstract

Background 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) metabolic parameters are prognostic indicators in several neoplasms. This study aimed to evaluate the prognostic value of the maximum and average standardized uptake value (SUVmax and SUVavg), metabolic tumor value (MTV), and total lesion glycolysis (TLG) measured in the primary tumor and suspicious lymph nodes preneoadjuvant therapy in patients submitted to surgical resection for esophageal cancer. Methods A cohort of 113 patients with esophageal cancer who performed 18F-FDG PET/CT preneoadjuvant therapy was assessed. The association of the SUV, MTV, and TLG measured in the primary tumor and in the suspicious lymph nodes with the overall survival was assessed. It was also analyzed other potentially confounding variables such as age, sex, clinical stage, and histologic subtype. The analyses were performed using Kaplan–Meier curve, log-rank test, and Cox regression. Results The univariate analyses showed that the MTV and TLG in the primary tumor, the SUV in the suspicious lymph nodes, the age, the histologic subtype, and the clinical stage were associated with survival after surgery (P ≤ 0.05). In the Cox regression multivariate analyses, all variables identified in the univariate analyses but the clinical stage were associated with survival after surgery (P ≤ 0.05). Conclusion In esophageal cancer patients, some of the 18F-FDG PET/CT metabolic parameters measured in the primary tumor and in the suspicious lymph nodes before the neoadjuvant therapy are independent indicators of overall survival and appear to be more important than the clinical stage in the prognostic definition of this group of patients.

FDG-PET/CT imaging parameters for predicting spontaneous regression of methotrexate-associated lymphoproliferative disorder in patients with rheumatoid arthritis

“…We investigated whether MTV and TLG calculated from FDG-PET/CT images acquired at the time of diagnosis can be used to predict the spontaneous regression of MTX-LPD. MTV and TLG are reported to be useful for predicting the prognosis of lung cancer 10 , 11 and esophageal cancer 12 , 13 , and Luo et al reported that MTV and TLG may predict the optimal timing of treatment for non-Hodgkin’s lymphoma 14 . However, various histological types of LPD are observed in MTX-LPD, and it is widely known that FDG uptake differs according to the histological type.…”

18F-FDG-PET/CT-measured parameters as potential predictors of residual disease after neoadjuvant chemoradiotherapy in patients with esophageal carcinoma

“…Despite the fact that the SUV and volumetric parameters are known to be associated with the long-term prognosis in esophageal cancer ( 6 - 13 , 21 ) , there are divergent results in the literature regarding the utility of 18 F-FDG-PET/CT in predicting the pathological response to nCRT ( 11 , 22 , 23 ) . Most of the relevant studies have used a variety of neoadjuvant regimens, have not assessed th 18 F-FDG-PET/CT parameters after nCRT, and have not taken a standardized approach to data analysis.…”

Volumetric Evaluation of Staging ¹⁸F-FDG PET/CT Images in Patients with Esophageal Cancer

“…Comparison of primary tumor MTV and TLG calculated from initial PET/CT images in patients with EC and treatment response, OS and progression-free survival have been investigated in various studies ( 14 , 15 , 16 , 17 , 18 , 19 ). A study reported that MTV and TLG of the primary tumor were associated with survival after surgery (p≤0.05) ( 16 ).…”

“…Comparison of primary tumor MTV and TLG calculated from initial PET/CT images in patients with EC and treatment response, OS and progression-free survival have been investigated in various studies ( 14 , 15 , 16 , 17 , 18 , 19 ). A study reported that MTV and TLG of the primary tumor were associated with survival after surgery (p≤0.05) ( 16 ). Another study, which included 151 EC patients, while MTV of the primary tumor was detected as an independent prognostic factor on OS (p=0.021), the SUV max of the primary tumor was not significant ( 17 ).…”