Sequential FDG-PET scanning in the assessment of response to neoadjuvant chemotherapy in operable esophageal cancer

Melcher, L.; Wong, Wai Lup; Sanghera, Bal; Bentzen, SM; Hall, Marcia; Chambers, Jane; Townsend, Edward R.; Fountain, William A.; Harrison, Mark

doi:10.1200/jco.2004.22.90140.4056

Cited by 3 publications

(3 citation statements)

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“…This study found no significant correlation of pre-treatment tumor uptake of C-11-Choline or F-18-FDG with pathological response, in keeping with previous reports [ 22 , 23 ]. We found, as did others [ 22 , 24 ], that change in uptake of either tracer at each time point could not significantly distinguish between each TRG. The percentage change in C-11-Choline at day 14 strongly correlated with TRG (r = 0.95, p = 0.05), although there were few responders in this group.…”

Section: Discussionsupporting

confidence: 73%

F-18-FDG and C-11-Choline Positron Emission Tomography in Human Esophago-Gastric Cancer: Prediction of Response to Therapy

et al. 2010

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BackgroundTo determine the utility of F-18-FDG and C-11-Choline uptake, in patients with esophageal and esophago-gastric junction tumors who are to undergo either neo-adjuvant or palliative chemotherapy, in predicting response (pathological and survival).MethodsEighteen patients with biopsy proven cancer were recruited prospectively. Patients underwent PET imaging before and during the first cycle of chemotherapy (seven and 14 days) with both F-18-FDG and C-11-Choline. Tracer uptake was quantified using Standardized Uptake Values. Pathological tumor response was determined using the Mandard criteria. Cellular proliferation was determined using ki-67 immunohistochemistry. Relationships between tracer uptake and response, one-year survival and cellular proliferation were determined.ResultsAll 18 tumors were imaged by F-18-FDG PET compared to 16/18 with C-11-Choline. Change in uptake of either tracer did not correlate with pathological response. Pathological response did not influence survival (median-survival, responders = 16.1 months; non-responders = 19.0 months, p = 0.978). There was no significant correlation of change in tracer uptake with survival. C-11-Choline tumor uptake did not correlate with cellular proliferation.ConclusionF-18-FDG PET is superior for imaging of the primary tumor. Neither F-18-FDG nor C-11-Choline PET was able to predict response accurately.

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Section: Discussionsupporting

confidence: 73%

F-18-FDG and C-11-Choline Positron Emission Tomography in Human Esophago-Gastric Cancer: Prediction of Response to Therapy

et al. 2010

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“…42 Unfortunately, current diagnostic modalities, including EUS and combined CT-PET scanning, cannot reliably assess the degree of response to chemoradiation. [9][10][11][43][44][45] Endoscopic ultrasound lacks the specificity to differentiate post-therapy scarring from residual live tumor. 12,13 A number of studies have investigated the usefulness of CT-PET in assessing the response to chemoradiation in esophageal cancer, with varied results.…”

Section: Discussionmentioning

confidence: 99%

“…8 One major problem hindering effective treatment in this context is that currently, there is no effective way to determine tumor response to chemoradiation, short of performing an esophagectomy. [9][10][11][12][13] management would be able to detect the presence of adenocarcinoma with high sensitivity and specificity and assess the effect of chemoradiation on tumor burden. An imaging modality with these capabilities would serve to facilitate the "real-time" evaluation of therapeutic effectiveness with serial scanning, potentially eliminate the need for surgery in complete responders, improve the quality of palliation by stopping chemoradiation in those who progress with therapy, improve prognostication based on tumor response, facilitate the evaluation of new therapies, and enhance the quality of clinical trials.…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Esophageal Adenocarcinoma Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Chang

Jerosch‐Herold

et al. 2008

Journal of Gastrointestinal Surgery

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Although neoadjuvant chemoradiation eradicates esophageal adenocarcinoma in a substantial proportion of patients, conventional imaging techniques cannot accurately detect this response. Dynamic contrast-enhanced magnetic resonance imaging is an emerging approach that may be well suited to fill this role. This pilot study evaluates the ability of this method to discriminate adenocarcinoma from normal esophageal tissue. Patients with esophageal adenocarcinoma and control subjects underwent scanning. Patients treated with neoadjuvant therapy underwent pre- and postchemoradiation scans. Parameters were extracted for each pixel were Ktrans (equilibrium rate for transfer of contrast reagent across the vascular wall), ve (volume fraction of interstitial space), and taui (mean intracellular water lifetime). Five esophageal adenocarcinoma patients and two tumor-free control subjects underwent scanning. The mean Ktrans value was 5.7 times greater in esophageal adenocarcinoma, and taui is 2.0 times smaller, than in the control subjects. Ktrans decreased by 11.4-fold after chemoradiation. Parametric maps qualitatively demonstrate a difference in Ktrans. DCE MRI of the esophagus is feasible. Ktrans, a parameter that has demonstrated discriminative ability in other malignancies, also shows promise in differentiating esophageal adenocarcinoma from benign tissue. The determination of Ktrans represents an in vivo assay for endothelial permeability and thus may serve as a quantitative measure of response to induction chemoradiation.

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Role of PET/PET CT in the staging and restaging of thoracic oesophageal cancer and gastro-oesophageal cancer: a literature review

Wong

Chambers

2007

Abdom Imaging

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Sequential FDG-PET scanning in the assessment of response to neoadjuvant chemotherapy in operable esophageal cancer

Cited by 3 publications

References 0 publications

F-18-FDG and C-11-Choline Positron Emission Tomography in Human Esophago-Gastric Cancer: Prediction of Response to Therapy

F-18-FDG and C-11-Choline Positron Emission Tomography in Human Esophago-Gastric Cancer: Prediction of Response to Therapy

The Evaluation of Esophageal Adenocarcinoma Using Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Role of PET/PET CT in the staging and restaging of thoracic oesophageal cancer and gastro-oesophageal cancer: a literature review

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