TY - JOUR
T1 - Preoperative Prediction of Pathologic Response to Neoadjuvant Chemoradiotherapy in Patients With Esophageal Cancer Using 18F-FDG PET/CT and DW-MRI
T2 - A Prospective Multicenter Study
AU - Borggreve, Alicia S.
AU - Goense, Lucas
AU - van Rossum, Peter S.N.
AU - Heethuis, Sophie E.
AU - van Hillegersberg, Richard
AU - Lagendijk, Jan J.W.
AU - Lam, Marnix G.E.H.
AU - van Lier, Astrid L.H.M.W.
AU - Mook, Stella
AU - Ruurda, Jelle P.
AU - van Vulpen, Marco
AU - Voncken, Francine E.M.
AU - Aleman, Berthe M.P.
AU - Bartels-Rutten, Annemarieke
AU - Ma, Jingfei
AU - Fang, Penny
AU - Musall, Benjamin C.
AU - Lin, Steven H.
AU - Meijer, Gert J.
N1 - Funding Information:
This research was partially funded by Elekta Inc and by National Institutes of Health / National Cancer Institute Cancer Center support grant P30CA016672 .
Funding Information:
Disclosures: R.v.H. and J.P.R. are proctoring surgeons for Intuitive Surgical Inc and train other surgeons in robot-assisted minimally invasive esophagectomy. J.J.W. receives research funding from Elekta Inc. S.H.L. receives research funding from Elekta Inc, Genentech, Hitachi Chemicals, New River Labs, and Beyond Spring Pharmaceuticals and is a member of the Advisory Board of AstraZeneca. All of the above are not in conflict with the research in question. All other authors have nothing to disclose.
Funding Information:
This research was partially funded by Elekta Inc and by National Institutes of Health/National Cancer Institute Cancer Center support grant P30CA016672. Disclosures: R.v.H. and J.P.R. are proctoring surgeons for Intuitive Surgical Inc and train other surgeons in robot-assisted minimally invasive esophagectomy. J.J.W. receives research funding from Elekta Inc. S.H.L. receives research funding from Elekta Inc, Genentech, Hitachi Chemicals, New River Labs, and Beyond Spring Pharmaceuticals and is a member of the Advisory Board of AstraZeneca. All of the above are not in conflict with the research in question. All other authors have nothing to disclose.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.ijrobp.2019.12.038
DO - 10.1016/j.ijrobp.2019.12.038
M3 - Article
C2 - 31987972
AN - SCOPUS:85079543430
SN - 0360-3016
VL - 106
SP - 998
EP - 1009
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 5
ER -