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首页> 外文期刊>The Journal of Nuclear Medicine >Accuracy of F-18-FDG PET/CT in Predicting Residual Disease After Neoadjuvant Chemoradiotherapy for Esophageal Cancer
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Accuracy of F-18-FDG PET/CT in Predicting Residual Disease After Neoadjuvant Chemoradiotherapy for Esophageal Cancer

机译：F-18-FDG PET / CT在Neoadjuvant ChemoRADICATION治疗食管癌后预测残留疾病的准确性

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Our purpose was to prospectively investigate optimal evaluation of qualitative and quantitative F-18-FDG PET/CT in response evaluations 12-14 wk after neoadjuvant chemoradiotherapy (nCRT) in esophageal cancer patients. Methods: This was a side study of the prospective diagnostic pre-SANO trial. F-18-FDG PET/CT scans at baseline and at 12-14 wk after nCRT were qualitatively assessed for the presence of tumor. Maximum SUVs normalized for lean body mass (SULmax) were measured in all scans. The primary endpoint was the proportion of false-negative patients with tumor regression grade (TRG) 3-4 (>10% vital residual tumor) in qualitative and quantitative analyses. Receiver-operating-characteristic curve analysis for TRG1 versus TRG3-4 using SULmax, SULmax tumor-to-esophagus ratio, and Delta%SULmax was performed to define optimal cutoffs. Secondary endpoints were sensitivity, specificity, negative predictive value, and positive predictive value for TRG1 versus TRG2-4. Results: In total, 129 of 219 patients were analyzed. Qualitative F-18-FDG PET/CT was unable to detect TRG3-4 in 15% of patients. Sensitivity, specificity, negative predictive value, and positive predictive value in qualitative analysis for detecting TRG1 versus TRG2-4 was 80%, 37%, 42%, and 77%, respectively. In 18 of 190 patients (10%) with follow-up scans after nCRT, F-18-FDG PET/CT identified new interval metastases. Quantitative parameters did not detect TRG3-4 tumor in 27%-61% of patients. The optimal cutoff for detecting TRG1 versus TRG2-4 was a post-nCRT SULmax of 2.93 (area under receiver-operating-characteristic curve, 0.70). Conclusion: Qualitative and quantitative analyses of F-18-FDG PET/CT are unable to accurately detect TRG3-4 and to discriminate substantial residual disease from benign inflammation-induced F-18-FDG uptake after nCRT. However, F-18-FDG PET/CT is useful for the detection of interval metastases and might become useful in an active surveillance strategy with serial F-18-FDG PET/CT scanning.
机译：我们的目的是在食管癌患者中新辅助化学化学疗法（NCRT）后，预先调查对响应评估的定性和定量F-18-FDG PET / CT的最佳评估。方法：这是对前瞻性诊断前试验的一面研究。在基线的F-18-FDG PET / CT扫描，NCRT在NCRT的情况下在质量评估肿瘤的情况下进行12-14周。在所有扫描中测量为贫体质量（Sulmax）标准化的最大SUVs。主要终点是定性和定量分析中肿瘤回归等级（TRG）3-4（TRG）3-4（TRG）3-4（> 10％至关重要的残留肿瘤）的比例。进行Trg1与TrG3-4的接收器操作特征曲线分析，使用Sulmax，Sulmax肿瘤到食道比和Delta％Sulmax以定义最佳截止值。辅助端点是TRG1与TRG2-4的敏感性，特异性，负预测值和阳性预测值。结果：分析了219例患者129例。定性F-18-FDG PET / CT无法在15％的患者中检测TRG3-4。检测Trg1与TRG2-4的定性分析中的敏感性，特异性，阴性预测值和阳性预测值分别为80％，37％，42％和77％。在190名患者中的18名（10％）中，NCRT后随访扫描，F-18-FDG PET / CT确定了新的间隔转移。定量参数在27％-61％的患者中检测到TRG3-4肿瘤。检测TRG1与TRG2-4的最佳截止值是2.93的后NCRT Sulmax（接收器 - 操作特征曲线下的区域，0.70）。结论：F-18-FDG PET / CT的定性和定量分析无法准确地检测TRG3-4，并在NCRT后从良性炎症诱导的F-18-FDG摄取区分大量残留疾病。然而，F-18-FDG PET / CT可用于检测间隔转移，并且可能在具有串行F-18-FDG PET / CT扫描的主动监测策略中有用。

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