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European Journal of Nuclear Medicine and Molecular Imaging

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01-01-2021 | Esophagus Resection | Original Article

Clinical response assessment on DW-MRI compared with FDG-PET/CT after neoadjuvant chemoradiotherapy in patients with oesophageal cancer

Authors: Sophie E. Vollenbrock, Francine E. M. Voncken, Doenja M. J. Lambregts, Monique Maas, Maarten L. Donswijk, Erik Vegt, Leon C. ter Beek, Jolanda M. van Dieren, Johanna W. van Sandick, Berthe M. P. Aleman, Regina G. H. Beets-Tan, Annemarieke Bartels-Rutten

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 1/2021

Abstract

Purpose

In about 30% of patients treated with neoadjuvant chemoradiotherapy (nCRT) followed by surgical resection for locally advanced oesophageal cancer no vital tumour is found in the resection specimen. Accurate clinical response assessment is critical if deferral from surgery is considered in complete responders. Our study aimed to compare the performance of MRI and of FDG-PET/CT for the detection of residual disease after nCRT.

Methods

Patients with oesophageal cancer eligible for nCRT and oesophagectomy were prospectively included. All patients underwent FDG-PET/CT and MRI before and between 6 and 8 weeks after nCRT. Two radiologists scored the MRI scans, and two nuclear medicine physicians scored the FDG-PET/CT scans using a 5-point score for residual disease. Histopathology after oesophagectomy represented the reference standard. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were calculated for detection of residual tumour (ypT+), residual nodal disease (ypN+), and any residual disease (ypT+Nx/ypT0N+).

Results

Seven out of 33 (21%) patients had a pathological complete response. The AUCs for individual readers to detect ypT+ were 0.71/0.70 on diffusion-weighted (DW)-MRI and 0.54/0.57 on FDG-PET/CT, and to detect ypN+ were 0.89/0.81 on DW-MRI and 0.75/0.71 on FDG-PET/CT. The AUCs/sensitivities/specificities for the individual readers to detect any residual disease were 0.74/92%/57% and 0.70/96%/43% on MRI; these were 0.49/69%/29% and 0.60/69%/43% on FDG-PET/CT, respectively.

Conclusion

MRI reached higher diagnostic accuracies than FDG-PET/CT for the detection of residual tumour in oesophageal cancer patients at 6 to 8 weeks after nCRT.

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Title: Clinical response assessment on DW-MRI compared with FDG-PET/CT after neoadjuvant chemoradiotherapy in patients with oesophageal cancer
Authors: Sophie E. Vollenbrock
Francine E. M. Voncken
Doenja M. J. Lambregts
Monique Maas
Maarten L. Donswijk
Erik Vegt
Leon C. ter Beek
Jolanda M. van Dieren
Johanna W. van Sandick
Berthe M. P. Aleman
Regina G. H. Beets-Tan
Annemarieke Bartels-Rutten
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Keywords: Esophagus Resection
Esophagus Resection
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 1/2021
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-020-04917-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical response assessment on DW-MRI compared with FDG-PET/CT after neoadjuvant chemoradiotherapy in patients with oesophageal cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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