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

被引：63

作者：

Borggreve, Alicia S. ^{[1
,2
]}

Goense, Lucas ^{[1
,2
]}

van Rossum, Peter S. N. ^{[1
]}

Heethuis, Sophie E. ^{[1
]}

van Hillegersberg, Richard ^{[2
]}

Lagendijk, Jan J. W. ^{[1
]}

Lam, Marnix G. E. H. ^{[3
]}

van Lier, Astrid L. H. M. W. ^{[1
]}

Mook, Stella ^{[1
]}

Ruurda, Jelle P. ^{[2
]}

van Vulpen, Marco ^{[4
]}

Voncken, Francine E. M. ^{[5
]}

Aleman, Berthe M. P. ^{[5
]}

Bartels-Rutten, Annemarieke ^{[6
]}

Ma, Jingfei ^{[7
]}

Fang, Penny ^{[8
]}

Musall, Benjamin C. ^{[7
]}

Lin, Steven H. ^{[8
]}

Meijer, Gert J. ^{[1
]}

机构：

[1] Univ Utrecht, Univ Med Ctr Utrecht, Dept Radiat Oncol, Utrecht, Netherlands

[2] Univ Utrecht, Univ Med Ctr Utrecht, Dept Surg, Utrecht, Netherlands

[3] Univ Utrecht, Univ Med Ctr Utrecht, Dept Nucl Med, Utrecht, Netherlands

[4] Proton Therapy Ctr Delft, Delft, Netherlands

[5] Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Radiat Oncol, Amsterdam, Netherlands

[6] Antoni van Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Radiol, Amsterdam, Netherlands

[7] Univ Texas MD Anderson Canc Ctr, Dept Imaging Phys, Houston, TX 77030 USA

[8] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA

来源：

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2020年 / 106卷 / 05期

基金：

美国国家卫生研究院;

关键词：

POSITRON-EMISSION-TOMOGRAPHY; FDG PET; THERAPY; CARCINOMA; CHEMORADIATION; SURVIVAL;

D O I：

10.1016/j.ijrobp.2019.12.038

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

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 F-18-fluorodeoxyglucose positron emission tomography with integrated computed tomography (F-18-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 (18)FFDG 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 F-18-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 F-18-FDG PET/CT and DW-MRI. Results: pCR was found in 26.1% of 69 patients. Relative changes in F-18-FDG PET/CT parameters after nCRT (Delta standardized uptake value [SUV](mean,post) P = .016, and Delta total lesion glycolysis (post) P = .024), as well as changes in DW-MRI parameters during nCRT (Delta 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 Delta ADC(during), Delta SUVmean,post, and histology in classifying patients as pCR (versus 0.82 for Delta ADC(during) and 0.79 for Delta SUVmean, post alone). Conclusions: Changes on F-18-FDG PET/CT after nCRT and early changes on DWMRI during nCRT can help identify pCR to nCRT in esophageal cancer. Moreover, F-18-FDG PET/CT and DW-MRI might be of complementary value in the assessment of pCR. (C) 2020 Elsevier Inc. All rights reserved.

引用

页码：998 / 1009

页数：12

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