Comparison of barium swallow, CT and thallium-201 SPECT in evaluating responses of patients with esophageal squamous cell carcinoma to preoperative chemoradiotherapy.
The aims of this study were to compare the results of thallium-201 (Tl-201) SPECT, barium swallow and CT in the assessment of the effect of preoperative chemoradiotherapy. This study consisted of 28 patients with advanced esophageal squamous cell carcinoma (AESCC) who underwent the three imaging modalities before and after preoperative chemoradiotherapy. The results were quantified using the bidimensional method for barium swallow and contrast-enhanced CT and the tumor-to-lung ratio for SPECT. The percent decrease in these quantitative values after therapy was defined as %Dba, %Dct and %Dtl respectively. The histological effect of the chemoradiotherapy was determined from the resected surgical specimen of the esophagus: grade 0, 100% viable tumor cells; grade 1a, 99-67%; grade 1b, 66-34%; grade 2, 33-1%; grade 3, no viable cells. A statistically significant difference of %Dtl between the subgroups of each grade was evident (p = 0.0433), whereas no significant differences were evident for %Dba (p = 0.1778) or %Dct (p = 0.7377). However, the overlap of %Dtl between these groups was marked. Although thallium-201 SPECT cannot be used to evaluate the therapeutic effect with acceptable accuracy, SPECT may be of additional value to barium swallow and CT in assessing the response of AESCC to preoperative chemoradiotherapy.
Nakahara
Tadaki
T
Division of Nuclear Medicine, Chiba Cancer Center Hospital, Japan. n-tadaki0909@k6.dion.ne.jp
Togawa
Takashi
T
Nagata
Matsuo
M
Kikuchi
Kazunori
K
Hatano
Kazuo
K
Yui
Nobuharu
N
Kubo
Atsushi
A
D000284:Administration, Oral; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001464:Barium / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D011878:Radiotherapy / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013793:Thallium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D003287:Contrast Media; D019275:Radiopharmaceuticals; D001464:Barium; C027549:thallium chloride; D013793:Thallium