title: Evaluation of response to induction chemotherapy in esophageal cancer: is barium esophagography or PET-CT useful?
abstract: OBJECTIVE
  To determine whether sequential barium esophagograms can predict histopathological response to treatment in esophageal cancer.
  
  
  METHODS
  Two radiologists retrospectively reviewed esophagograms pre- and post- chemotherapy in 32 patients for tumor length decrease of at least 15% and luminal width increase of at least 15%. Positron emission tomography-computed tomography (PET-CT) was reviewed for tumor maximum standardized uptake value (SUVmax) decrease of at least 35%. The reference standard was 90% or more tumor necrosis at histopathologic examination of the excised specimen.
  
  
  RESULTS
  Pathologic response ranged from 10% to 100% necrosis. For prediction of tumor response, the sensitivity, specificity, positive and negative predictive values for length ranged from 43.8 to 56.3% and for width from 41.2% to 66.7% and for SUVmax from 47.1% to 53.3%.
  
  
  CONCLUSIONS
  Performance characteristics for barium esophagograms in our group of patients were similar to PET-CT in predicting tumor response. Both tests were inadequate in predicting tumor response.
authors.affiliation: Raffles Hospital, 585 North Bridge Road, Singapore 188770, Singapore. engcheeway@yahoo.com.sg
authors.forename: Chee Way
authors.initials: CW
authors.lastname: Eng
authors.forename: James Louis
authors.initials: JL
authors.lastname: Fuqua
authors.forename: Ravinder
authors.initials: R
authors.lastname: Grewal
authors.forename: David
authors.initials: D
authors.lastname: Ilson
authors.forename: Antoine Cosme David
authors.initials: AC
authors.lastname: Messiah
authors.forename: Nabil
authors.initials: N
authors.lastname: Rizk
authors.forename: Laura
authors.initials: L
authors.lastname: Tang
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Gollub
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001466:Barium Sulfate; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002945:Cisplatin / Q000008:administration & dosage; D003287:Contrast Media; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D000077146:Irinotecan; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D011379:Prognosis; D012074:Remission Induction; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin