Mitsuaki Tatsumi MD, PhD, Presenter: Nothing to Disclose

Masahiro Yanagawa MD, PhD, Abstract Co-Author: Nothing to Disclose

Tadashi Watabe, Abstract Co-Author: Nothing to Disclose

Tonsok Kim MD, Abstract Co-Author: Nothing to Disclose

Noriyuki Tomiyama MD, PhD, Abstract Co-Author: Nothing to Disclose

Jun Hatazawa MD, PhD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to evaluate if parameters obtained from SUV-volume histogram of whole tumor on FDG PET/CT were useful in predicting treatment response of neoadjuvant chemotherapy and recurrence after subsequent surgery in patients with esophageal cancer.

Pretreatment FDG PET/CT exams in 41 esophageal cancer patients were analyzed retrospectively. Kurtosis, skewness, and coefficient of variation (CV) were obtained as parameters of SUV-volume histogram, which was generated from a 3D region-of-interest covering whole esophageal cancer lesion on PET/CT. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were also obtained as volumetric parameters. The area under a cumulative SUV-volume histogram curve (AUC-CSH) was calculated as a parameter to estimate intratumoral heterogeneity. These parameters were compared to each other and to pathologic results of chemotherapeutic response and recurrent status after subsequent surgery.

Kurtosis, skewness, and CV showed close relationships between the two of them (Rho= 0.7 - 0.97 , p<0.001 for each). Kurtosis, skewness, or CV correlated well to AUC-CSH (Rho= -0.61, -0.71, and -0.81, p<0.001 for each), respectively, but none of them correlated to SUV, MTV, nor TLG. Kurtosis or skewness correlated to the pathologic response (Rho= 0.35 and 0.36, p<0.05 for each) as well as to the recurrence (Rho= -0.31 and -0.36, p<0.05 for each), respectively. None of SUV, MTV, TLG, and AUC-CSH had a statistical correlation to the pathologic response nor recurrence in this study.

This study demonstrated the potential of kurtosis or skewness from SUV-volume histogram in predicting pathologic response and recurrence after neoadjuvant chemotherapy and surgery in esophageal cancer. Further studies are warranted to confirm the clinical impact of these parameters and the association with intratumoral heterogeneity.

Kurtosis or skewness from SUV-volume histogram on FDG PET/CT may be useful in predicting pathologic response and recurrence after neoadjuvant chemotherapy and surgery in esophageal cancer.

Tatsumi, M, Yanagawa, M, Watabe, T, Kim, T, Tomiyama, N, Hatazawa, J, Prediction of Treatment Response and Recurrence with SUV-volume Histogram Analysis on FDG PET/CT in Patients with Esophageal Cancer Receiving Neoadjuvant Chemotherapy and Surgery.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045553.html