title: FDG-PET in the prediction of pathologic response after neoadjuvant chemoradiotherapy in locally advanced, resectable esophageal cancer.
abstract: OBJECTIVE
  To assess the efficacy of 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) for predicting a pathologic response in locally advanced esophageal cancer after neoadjuvant chemoradiotherapy.
  
  
  METHODS
  All enrolled patients were treated with neoadjuvant chemoradiotherapy followed by esophagectomy and underwent two FDG-PET scans, before and after neoadjuvant chemoradiotherapy. We compared the results of the preoperative FDG-PET scans with the pathologic results.
  
  
  RESULTS
  From July 2001 to July 2004, 32 patients (29 men and 3 women) were enrolled in this study. Pathologic complete response (pCR) in the esophagus was achieved in 21 of 32 patients (66%). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the primary tumors of the preoperative FDG-PET were 27%, 95%, 75%, and 71%, respectively. In regional lymph nodes, these values were 16%, 98%, 36%, and 93%, respectively. The mean standardized uptake value (SUV) of primary tumors was initially 5.6 +/- 3.6 and changed to 1.5 +/- 1.3 after neoadjuvant chemoradiotherapy (p < 0.05). If analysis of metabolic response (SUV decrease, DeltaSUV) was limited to initially highly metabolic primary tumors (SUV > or =4.0), pathologic response was correlated with metabolic response (p = 0.006).
  
  
  CONCLUSIONS
  This study suggested that the pathologic response of an initially highly metabolic tumor after neoadjuvant chemoradiotherapy could be correlated with the metabolic response, and FDG-PET can provide additional information on tumor response to chemoradiotherapy.
authors.affiliation: Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea.
authors.forename: Si Yeol
authors.initials: SY
authors.lastname: Song
authors.forename: Jong Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Jin Sook
authors.initials: JS
authors.lastname: Ryu
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Sung Bae
authors.initials: SB
authors.lastname: Kim
authors.forename: Seung Il
authors.initials: SI
authors.lastname: Park
authors.forename: Ho-Young
authors.initials: HY
authors.lastname: Song
authors.forename: Kyung-Ja
authors.initials: KJ
authors.lastname: Cho
authors.forename: Seung Do
authors.initials: SD
authors.lastname: Ahn
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Lee
authors.forename: Seong Soo
authors.initials: SS
authors.lastname: Shin
authors.forename: Eun Kyung
authors.initials: EK
authors.lastname: Choi
mesh_terms: D000368:Aged; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D016629:Esophagectomy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D018714:Radiotherapy, Adjuvant; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18