Using {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography to Estimate the Length of Gross Tumor in Patients With Squamous Cell Carcinoma of the Esophagus

Journal Article · Thu Jan 01 04:00:00 EST 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.04.015· OSTI ID:21172544

Xiaojun, Zhong ^[1]; Baijiang, Zhang ^[2]; Dianbin, Mu ^[3]; Weidi, Zhang; Daotang, Li ^[2]; Anqin, Han ^[4]; Pingping, Song; Hui, Li ^[2]; Guoren, Yang ^[4]; Fengming, Kong ^[5]; Zheng, Fu ^[4]

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1. Department of Radiation Oncology, Tianjin Medical University Cancer Hospital and Institute, Tianjin (China)
2. Department of Thoracic Surgery, Shandong Cancer Hospital and Institute, Jinan (China)
3. Department of Pathology, Shandong Cancer Hospital and Institute, Jinan (China)
4. Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Jinan (China)
5. Sino-American Network for Therapeutic Radiology and Oncology, and Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States)

Purpose: To determine the optimal method of using {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) to estimate gross tumor length in esophageal carcinoma. Methods and Materials: Thirty-six patients with esophageal squamous cell carcinoma treated with radical surgery were enrolled. Gross tumor volumes (GTVs) were delineated using three different methods: visual interpretation, standardized uptake value (SUV) 2.5, and 40% of maximum standard uptake value (SUV{sub max}) on FDG-PET imaging. The length of tumors on PET scan were measured and recorded as Length{sub vis}, Length{sub 2.5}, and Length{sub 40}, respectively, and compared with the length of gross tumor in the resected specimen (Length{sub gross}). All PET data were reviewed again postoperatively, and the GTV was delineated using various percentages of SUV{sub max}. The optimal-threshold SUV was generated when the length of PET matched the Length{sub gross}. Results: The mean ({+-}SD) Length{sub gross} was 5.48 {+-} 1.98 cm. The mean Length{sub vis}, Length{sub 2.5}, and Length{sub 40} were 5.18 {+-} 1.93 cm, 5.49 {+-} 1.79 cm, and 4.34 {+-} 1.54 cm, respectively. The mean Length{sub vis} (p = 0.123) and Length{sub 2.5} (p = 0.957) were not significantly different from Length{sub gross}, and Length{sub 2.5} seems more approximate to Length{sub gross.} The mean Length{sub 40} was significantly shorter than Length{sub gross} (p < 0.001). The mean optimal threshold was 23.81% {+-} 11.29% for all tumors, and it was 19.78% {+-} 8.59%, 30.92% {+-} 12.28% for tumors {>=}5 cm, and <5 cm, respectively (p = 0.009). The correlation coefficients of the optimal threshold were -0.802 and -0.561 with SUV{sub max} and Length{sub gross}, respectively. Conclusions: The optimal PET method to estimate the length of gross tumor varies with tumor length and SUV{sub max}; an SUV cutoff of 2.5 provided the closest estimation in this study.

• OSTI ID: 21172544
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 73; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
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RADIOTHERAPY
SURGERY
UPTAKE