title: Prognostic significance of 18-FDG PET/CT and EUS-defined tumour characteristics in patients with oesophageal cancer.
abstract: OBJECTIVE
  To determine the correlation between 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography/computed tomography (PET/CT) defined maximum standardized uptake value (SUVmax) and endoluminal ultrasound-defined tumour volume (EDTV) in patients with oesophageal cancer (OC) and their relative prognostic significance.
  
  
  METHODS
  One hundred and eighty-five consecutive patients with OC were staged using CT, endoscopic ultrasound (EUS), and PET/CT. The maximum potential EDTV was calculated (πr(2)L, where r = tumour thickness and L = total length of disease including proximal and distal lymph node metastases). Primary outcome measure was survival from diagnosis.
  
  
  RESULTS
  Ninety-one percent of patients (168/185) had FDG-avid tumours on PET/CT. SUVmax correlated positively and significantly with EDTV (Spearman's rho = 0.339, p = 0.001). On univariate analysis, survival was inversely related to the PET/CT lymph node metastasis count (LNMC, p = 0.015), EUS N stage (p = 0.002), EDTV (<48 cm(3), p = 0.001), EUS total length of disease (p = 0.001), SUVmax (p = 0.002), PET/CT N stage (p < 0.0001), and EUS LNMC (p < 0.0001). On multivariate analysis two factors were significantly and independently associated with survival: EDTV (HR, 3.118; 95% CI: 1.357-7.167; p = 0.007), and PET/CT N stage (HR, 0.496; 95% CI: 0.084-1.577; p = 0.022).
  
  
  CONCLUSIONS
  EDTV and PET/CT N stage were important predictors of survival and further research is needed to identify critical prognostic values.
authors.affiliation: Department of Surgery, University Hospital of Wales, Cardiff, UK. dcsy23@gmail.com
authors.forename: D S Y
authors.initials: DS
authors.lastname: Chan
authors.forename: P
authors.initials: P
authors.lastname: Fielding
authors.forename: S A
authors.initials: SA
authors.lastname: Roberts
authors.forename: T D
authors.initials: TD
authors.lastname: Reid
authors.forename: R
authors.initials: R
authors.lastname: Ellis-Owen
authors.forename: W G
authors.initials: WG
authors.lastname: Lewis
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy; D018572:Disease-Free Survival; D019160:Endosonography / Q000379:methods*; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D004947:Esophagus / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18