Preoperative Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients With Esophageal Cancer Using 18F-FDG PET/CT and DW-MRI: A Prospective Multicenter Study.
Alicia S Borggreve,Lucas Goense,Peter S.N. van Rossum,Sophie E Heethuis,Richard van Hillegersberg,Jan J W Lagendijk,Marnix G.E.H. Lam,Astrid L.H.M.W. van Lier,Stella Mook,Jelle P. Ruurda,Marco van Vulpen,Francine E.M. Voncken,Berthe M.P. Aleman,Annemarieke Bartels-Rutten,Jingfei Ma,Penny Fang,Benjamin C. Musall,Steven H. Lin,Gert J. Meijer +18 more
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Changes on 18F-FDG PET/CT after nCRT and early changes on DW-MRI during nCRt can help identify pCR to n CRT in esophageal cancer.Abstract:
Purpose Accurate preoperative prediction of pathologic response to neoadjuvant chemoradiotherapy (nCRT) in patients with esophageal cancer could enable omission of esophagectomy in patients with a pathologic complete response (pCR). This study aimed to evaluate the individual and combined value of 18F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (18F-FDG PET/CT) and diffusion-weighted magnetic resonance imaging (DW-MRI) during and after nCRT to predict pathologic response in patients with esophageal cancer. Methods and Materials In this multicenter prospective study, patients scheduled to receive nCRT followed by esophagectomy for esophageal cancer underwent 18F-FDG PET/CT and DW-MRI scanning before the start of nCRT, during nCRT, and before esophagectomy. Response to nCRT was based on histopathologic evaluation of the resection specimen. Relative changes in 18F-FDG PET/CT and DW-MRI parameters were compared between patients with pCR and non-pCR groups. Multivariable ridge regression analyses with bootstrapped c-indices were performed to evaluate the individual and combined value of 18F-FDG PET/CT and DW-MRI. Results pCR was found in 26.1% of 69 patients. Relative changes in 18F-FDG PET/CT parameters after nCRT (Δ standardized uptake value [SUV]mean,post P = .016, and Δ total lesion glycolysis post P = .024), as well as changes in DW-MRI parameters during nCRT (Δ apparent diffusion coefficient [ADC]during P = .008) were significantly different between pCR and non-pCR. A c-statistic of 0.84 was obtained for a model with ΔADCduring, ΔSUVmean,post, and histology in classifying patients as pCR (versus 0.82 for ΔADCduring and 0.79 for ΔSUVmean,post alone). Conclusions Changes on 18F-FDG PET/CT after nCRT and early changes on DW-MRI during nCRT can help identify pCR to nCRT in esophageal cancer. Moreover, 18F-FDG PET/CT and DW-MRI might be of complementary value in the assessment of pCR.read more
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Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients with Esophageal Squamous Cell Carcinoma Incorporating Hematological Biomarkers.
TL;DR: A nomogram incorporating hematological biomarkers to predict pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC) was developed and internally validated, showing good predictive performance.
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18F-FDG PET/CT Parameters for Predicting Prognosis in Esophageal Cancer Patients Treated With Concurrent Chemoradiotherapy:
TL;DR: In this article, the authors evaluated the prognostic value of 18F-fluorodeoxyglucose positron emission tomography with integrated computed tomography (18F-FDG PET/CT) performed before and after the insertion of positron positron emissions.
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Thomas Steffen,Daniel Dietrich,Annelies Schnider,Christoph Kettelhack,Olivier Huber,Walter R. Marti,Markus Furrer,Beat Gloor,Marc Schiesser,Sandra Thierstein,Peter Brauchli,Thomas Ruhstaller +11 more
TL;DR: After curative surgery in a multimodal setting, the histological type and the response to neoadjuvant therapy predicted the time frame of relapse; this knowledge may influence further follow-up guidelines for esophageal carcinoma.
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Multimodal Imaging of Pathologic Response to Chemoradiation in Esophageal Cancer.
Penny Fang,Benjamin C. Musall,Jong Bum Son,Amy C. Moreno,Brian P. Hobbs,Brett W. Carter,Bryan Fellman,Osama Mawlawi,Jingfei Ma,Steven H. Lin +9 more
TL;DR: Quantitative volume ΔADC and TLG during treatment may serve as early imaging biomarkers for discriminating pathologic response to chemoradiation in esophageal cancer.