Nucl Med Mol Imaging.  2022 Aug;56(4):181-187. 10.1007/s13139-022-00751-9.

Pretreatment ¹⁸F‑FDG PET/CT‑Derived Parameters in Predicting Clinical Outcomes of Locally Advanced Upper Third Esophageal Squamous Cell Carcinoma After Definitive Chemoradiation Therapy

• Ha L
• Chau N
• Bieu B
• Son M

• KMID: 2532368
• DOI: http://doi.org/10.1007/s13139-022-00751-9

Abstract

Purpose
The aim of this study was to investigate whether standard uptake values (SUVs) of pretreatment ¹⁸F-FDG PET/CT were the surrogate parameters for predicting the outcomes in locally advanced esophageal squamous cell carcinoma patients treated with definitive chemoradiotherapy.
Materials and Methods
Sixty patients with esophageal squamous cell carcinoma underwent pretreatment ¹⁸F-FDG PET/CT and received definitive chemoradiotherapy. ¹⁸F-FDG metabolic parameters including SUVmax, SUVmean, SULpeak, total lesion glycolysis (TLG), and metabolic tumor volume (MTV) of primary tumor were calculated. The receiver-operating characteristic (ROC) curve was used to determine the optimal cutoff value of FDG PET/CT-derived parameters that associated with treatment response. Estimating progression-free survival (PFS) and overall survival (OS) was analyzed by using Kaplan–Meier methods. Univariate and multivariate analysis for PFS and OS was performed using Cox regression.
Results
Complete response was achieved in 38.3%. The 4-year OS and PFS rates were 48.6% and 44.4%, respectively. SUVmean with a cutoff value of 6.1 could predict complete response with sensitivity of 69.6%, specificity of 78.4%, and accuracy of 75%. Cox multi-factor regression analyses revealed SUVmean > 6.1 as an independent prognostic factor for OS (HR = 6.74, p = 0.02) and PFS (HR = 6.53, p < 0.001).
Conclusions
Our study suggests that SUVmean of the primary tumor in pretreatment ¹⁸F-FDG PET/CT may be used as an independent predictor in esophageal squamous cell carcinoma patients treated with definitive chemoradiotherapy.

Keyword

¹⁸F-FDG PET/CT; Standard uptake value; SUVmean; Prognosis; Esophageal squamous cell carcinoma; Definitive chemoradiotherapy