Research Papers:

18F-deoxyglucose positron emission tomography/computed tomography to predict local failure in esophageal squamous cell carcinoma

Bingjie Fan, Pingping Fan, Li Kong, Xindong Sun, Shuqiang Zhao, Xiaorong Sun, Zheng Fu, Jinsong Zheng, Li Ma, Shijiang Wang, Man Hu _ and Jinming Yu

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Oncotarget. 2017; 8:34498-34506. https://doi.org/10.18632/oncotarget.15606

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Bingjie Fan1, Pingping Fan1,2,3, Li Kong1,2,3, Xindong Sun1,2,3, Shuqiang Zhao1,2,4, Xiaorong Sun1,2,4, Zheng Fu1,2,4, Jinsong Zheng1,2,4, Li Ma1,2,4, Shijiang Wang1,2,3, Man Hu1,2,3 and Jinming Yu1,2,3

1Shandong Cancer Hospital Affiliated to Shandong University, Jinan, China

2Shandong Academy of Medical Sciences, Jinan, China

3Departments of Radiation Oncology and Shandong Province Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, China

4Departments of Nuclear Medicine, Shandong Cancer Hospital and Institute, Jinan, China

Correspondence to:

Man Hu, email: [email protected]

Jinming Yu, email: [email protected]

Keywords: esophageal squamous cell carcinoma, radiotherapy, FDG PET/CT, concurrent chemoradiotherapy, local failure

Received: October 15, 2016    Accepted: January 04, 2017    Published: February 22, 2017


Esophageal squamous cell carcinoma (ESCC) patients are at risk for local failure (LF) following treatment. Predicting tumor regions at high risk for local failure before radiotherapy may increase treatment efficacy by permitting an escalated radiation dose specifically to those regions critical for tumor control. Forty-one patients with non-resectable locally advanced ESCC underwent 18F-deoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging before concurrent chemoradiotherapy (CCRT). After CCRT, a second (failure) FDG PET/CT was performed in cases of relapse. Failure FDG PET/CT scans were fused to pre-treatment scans to identify tumor regions at high risk for LF. Within a median follow-up time of 26 months, 20 patients (48.8%) had LF. In 19 patients, the failure occurred within a pre-treatment high FDG uptake region; the failure occurred outside these regions in only one patient. Pre-treatment metabolic tumor volume (MTV) was independently associated with LF (P<0.001, HR 1.128, 95% CI: 1.061–1.198). LF was more likely in patients with MTVs ≥27 cm3. In initial PET/CT images, when 50% maximum standardized uptake value (SUVmax) was used as the threshold, delineated subvolumes overlapped LF regions. These results confirm that LF occurs most commonly within pre-treatment high FDG uptake regions.

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