Prognostic value of pretreatment 18F-FDG PET/CT metabolic parameters in esophageal high-grade neuroendocrine carcinoma: A bicenter retrospective study

Abstract

ObjectiveThe aim of this bicentric retrospective study was to assess the prognostic value of 18F-FDG PET/CT in patients with esophageal high-grade neuroendocrine carcinoma (NECs).MethodsFrom the database of two centers, 28 patients affected by esophageal high-grade NECs who underwent 18F-FDG PET/CT before treatment were retrospectively reviewed. Metabolic parameters (SUVmax, SUVmean, tumor-to-blood-pool SUV ratio (TBR), tumor-to-liver SUV ratio (TLR), metabolic tumor volume (MTV), total lesion glycolysis (TLG)) of the primary tumor were measured. Univariate and multivariate analyses were performed for progression-free survival (PFS) and overall survival (OS).ResultsAfter a median follow-up period of 22 months, disease progression occurred in 11 (39.3%) patients, and death occurred in 8 (28.6%) patients. The median PFS was 34 months, and the median OS was not reached. Univariate analyses revealed that among metabolic parameters, only MTV and TLG were significant prognostic factors, while among clinical variables, only distant metastasis was a significant factor for both PFS and OS (P< 0.05). On multivariate analyses, MTV and TLG were independent prognostic factors for both PFS and OS (P< 0.05).ConclusionsIn patients with esophageal high-grade NEC, MTV and TLG measured on pretreatment 18F-FDG PET/CT are independently prognostic factors for predicting PFS and OS, and might be used as quantitative prognostic imaging biomarkers.

Volumetric Parameters Derived from CXCR4-Directed PET/CT Predict Outcome in Patients with Gastrointestinal Neuroendocrine Carcinomas

“…Jiang et al showed a significant association between NECs of the uterine cervix in 22 patients and the volume as well as the lesion uptake solely of the primary tumor on FDG PET and PFS, whereas SUVmax of the primary tumor was not a prognostic marker [ 26 ]. Hou et al also described a significant prognostic value of TV and TLU on FDG PET in 28 patients with esophageal NECs [ 27 ]. The fact that FDG PET was not a prognostic tool in our cohort could be due to the small sample size in which a statistical significant effect does not break through.…”

A Case of Primary Esophageal Sarcomatoid Carcinoma Detected by 18F-FDG PET/CT

“…In this case, the esophageal sarcomatoid carcinoma represents a large soft tissue mass with high 18 F-FDG uptake on 18 F-FDG PET/CT. However, the 18 F-FDG PET/CT findings of esophageal sarcomatoid carcinoma are similar to part of esophageal squamous carcinoma, leiomyosarcoma, or neuroendocrine carcinoma, 10–12 which are difficult to distinguish. This case indicates that the esophageal sarcomatoid carcinoma should be taken into consideration as one of the possibilities when esophageal lesions with similar 18 F-FDG PET/CT findings.…”