Clinical usefulness of dual-time FDG PET-CT in assessment of esophageal squamous cell carcinoma

Weng Yoon Shum, Te Chun Hsieh, Jun Jun Yeh, Jin Hua Chen, Chih Chung Su, Ji An Liang, Chia Hung Kao

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose: We conducted this study to investigate the value of the dual-time 2-[ 18F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography-computed tomography (PET-CT) in assessment of the primary tumor, loco-regional lymph node and distant metastasis in patients with esophageal squamous cell carcinoma. Methods: Twenty-six patients with histologically proved esophageal squamous cell carcinoma underwent dual-time FDG PET-CT before radical surgery. The standardized uptake values (SUV max) were obtained including early SUV max and delayed SUV max, respectively. The retention index (RI) was also calculated. The results were evaluated retrospectively according to the final pathologic findings. Four diagnostic criteria including (1) early SUV max ≧ 2.5 alone, (2) RI ≧ 10% alone, (3) a combination of early SUV max ≧ 2.5 and RI ≧ 10%, and (4) a combination of early SUV max ≧ 2.5 or RI ≧ 10% were used for differentiating malignancy from a benign lesion, respectively. Results: The sensitivity of FDG PET-CT in detecting the primary tumor with combination of early SUV max ≧ 2.5 or RI ≧ 10% was 96.2%. It was statistically significantly higher than the results using the other three criteria (p <0.0001). For loco-regional lymph node detection, there was no significant difference among the 4 criteria. For distal metastases, the significantly higher specificity (100%) was found when using combination of early SUV max ≧ 2.5 and RI ≧ 10% or using early SUV max ≧ 2.5 alone than using the other two criteria (p = 0.0058). With regard to accuracy, no significant correlations were observed among primary tumor, loco-regional lymph nodes and distant metastasis (p > 0.05). Conclusion: The preliminary result of this study demonstrated that dual-time point FDG PET-CT had limited value in detection of primary tumor and loco-regional lymph nodes metastasis. For the distant metastasis, the sensitivity and specificity would be improved if RI ≧ 10% is used as a supplemental criterion. Efforts should be made to improve the ability of the dual-time FDG PET-CT technique to assess primary tumor and loco-regional lymph nodes metastasis.

Original languageEnglish
Pages (from-to)1024-1028
Number of pages5
JournalEuropean Journal of Radiology
Volume81
Issue number5
DOIs
Publication statusPublished - May 2012
Externally publishedYes

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Glucose
Neoplasm Metastasis
Lymph Nodes
Neoplasms
Positron Emission Tomography Computed Tomography
Esophageal Squamous Cell Carcinoma
Sensitivity and Specificity

Keywords

  • 2-[ F]fluoro-2-deoxy-d-glucose (FDG)
  • Esophageal squamous cell carcinoma
  • Positron emission tomography-computed tomography (PET-CT)
  • Retention index (RI)
  • Standardized uptake value (SUV )

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Clinical usefulness of dual-time FDG PET-CT in assessment of esophageal squamous cell carcinoma. / Shum, Weng Yoon; Hsieh, Te Chun; Yeh, Jun Jun; Chen, Jin Hua; Su, Chih Chung; Liang, Ji An; Kao, Chia Hung.

In: European Journal of Radiology, Vol. 81, No. 5, 05.2012, p. 1024-1028.

Research output: Contribution to journalArticle

Shum, Weng Yoon ; Hsieh, Te Chun ; Yeh, Jun Jun ; Chen, Jin Hua ; Su, Chih Chung ; Liang, Ji An ; Kao, Chia Hung. / Clinical usefulness of dual-time FDG PET-CT in assessment of esophageal squamous cell carcinoma. In: European Journal of Radiology. 2012 ; Vol. 81, No. 5. pp. 1024-1028.
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abstract = "Purpose: We conducted this study to investigate the value of the dual-time 2-[ 18F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography-computed tomography (PET-CT) in assessment of the primary tumor, loco-regional lymph node and distant metastasis in patients with esophageal squamous cell carcinoma. Methods: Twenty-six patients with histologically proved esophageal squamous cell carcinoma underwent dual-time FDG PET-CT before radical surgery. The standardized uptake values (SUV max) were obtained including early SUV max and delayed SUV max, respectively. The retention index (RI) was also calculated. The results were evaluated retrospectively according to the final pathologic findings. Four diagnostic criteria including (1) early SUV max ≧ 2.5 alone, (2) RI ≧ 10{\%} alone, (3) a combination of early SUV max ≧ 2.5 and RI ≧ 10{\%}, and (4) a combination of early SUV max ≧ 2.5 or RI ≧ 10{\%} were used for differentiating malignancy from a benign lesion, respectively. Results: The sensitivity of FDG PET-CT in detecting the primary tumor with combination of early SUV max ≧ 2.5 or RI ≧ 10{\%} was 96.2{\%}. It was statistically significantly higher than the results using the other three criteria (p <0.0001). For loco-regional lymph node detection, there was no significant difference among the 4 criteria. For distal metastases, the significantly higher specificity (100{\%}) was found when using combination of early SUV max ≧ 2.5 and RI ≧ 10{\%} or using early SUV max ≧ 2.5 alone than using the other two criteria (p = 0.0058). With regard to accuracy, no significant correlations were observed among primary tumor, loco-regional lymph nodes and distant metastasis (p > 0.05). Conclusion: The preliminary result of this study demonstrated that dual-time point FDG PET-CT had limited value in detection of primary tumor and loco-regional lymph nodes metastasis. For the distant metastasis, the sensitivity and specificity would be improved if RI ≧ 10{\%} is used as a supplemental criterion. Efforts should be made to improve the ability of the dual-time FDG PET-CT technique to assess primary tumor and loco-regional lymph nodes metastasis.",
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AU - Hsieh, Te Chun

AU - Yeh, Jun Jun

AU - Chen, Jin Hua

AU - Su, Chih Chung

AU - Liang, Ji An

AU - Kao, Chia Hung

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N2 - Purpose: We conducted this study to investigate the value of the dual-time 2-[ 18F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography-computed tomography (PET-CT) in assessment of the primary tumor, loco-regional lymph node and distant metastasis in patients with esophageal squamous cell carcinoma. Methods: Twenty-six patients with histologically proved esophageal squamous cell carcinoma underwent dual-time FDG PET-CT before radical surgery. The standardized uptake values (SUV max) were obtained including early SUV max and delayed SUV max, respectively. The retention index (RI) was also calculated. The results were evaluated retrospectively according to the final pathologic findings. Four diagnostic criteria including (1) early SUV max ≧ 2.5 alone, (2) RI ≧ 10% alone, (3) a combination of early SUV max ≧ 2.5 and RI ≧ 10%, and (4) a combination of early SUV max ≧ 2.5 or RI ≧ 10% were used for differentiating malignancy from a benign lesion, respectively. Results: The sensitivity of FDG PET-CT in detecting the primary tumor with combination of early SUV max ≧ 2.5 or RI ≧ 10% was 96.2%. It was statistically significantly higher than the results using the other three criteria (p <0.0001). For loco-regional lymph node detection, there was no significant difference among the 4 criteria. For distal metastases, the significantly higher specificity (100%) was found when using combination of early SUV max ≧ 2.5 and RI ≧ 10% or using early SUV max ≧ 2.5 alone than using the other two criteria (p = 0.0058). With regard to accuracy, no significant correlations were observed among primary tumor, loco-regional lymph nodes and distant metastasis (p > 0.05). Conclusion: The preliminary result of this study demonstrated that dual-time point FDG PET-CT had limited value in detection of primary tumor and loco-regional lymph nodes metastasis. For the distant metastasis, the sensitivity and specificity would be improved if RI ≧ 10% is used as a supplemental criterion. Efforts should be made to improve the ability of the dual-time FDG PET-CT technique to assess primary tumor and loco-regional lymph nodes metastasis.

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