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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 2/2017

01-02-2017 | Original Article

Texture analysis of 18F-FDG PET/CT to predict tumour response and prognosis of patients with esophageal cancer treated by chemoradiotherapy

Authors: Masatoyo Nakajo, Megumi Jinguji, Yoshiaki Nakabeppu, Masayuki Nakajo, Ryutarou Higashi, Yoshihiko Fukukura, Ken Sasaki, Yasuto Uchikado, Shoji Natsugoe, Takashi Yoshiura

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2017

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Abstract

Purpose

This retrospective study was done to examine whether the heterogeneity in primary tumour F-18-fluorodeoxyglucose (18F-FDG) distribution can predict tumour response and prognosis of patients with esophageal cancer treated by chemoradiotherapy (CRT).

Methods

The enrolled 52 patients with esophageal cancer underwent 18F-FDG-PET/CT studies before CRT. SUVmax, SUVmean, metabolic tumour volume (MTV, SUV ≥ 2.5), total lesion glycolysis (TLG) and six heterogeneity parameters assessed by texture analysis were obtained. Patients were classified as responders or non-responders according to Response Evaluation Criteria in Solid Tumors. Progression-free survival (PFS) and overall survival (OS) were calculated by the Kaplan–Meier method. Prognostic significance was assessed by Cox proportional hazards analysis.

Results

Thirty four non-responders showed significantly higher MTV (p = 0.006), TLG (p = 0.007), intensity variability (IV; p = 0.003) and size-zone variability (SZV; p = 0.004) than 18 responders. The positive and negative predictive values for non-responders were 77 % and 69 % in MTV, 76 % and 100 % in TLG, 78 % and 67 % in IV and 78 % and 82 % in SZV, respectively. Although PFS and OS were significantly shorter in patients with high MTV (PFS, p = 0.018; OS, p = 0.014), TLG (PFS, p = 0.009; OS, p = 0.025), IV (PFS, p = 0.013; OS, p = 0.007) and SZV (PFS, p = 0.010; OS, p = 0.007) at univariate analysis, none of them was an independent factor, while lymph node status, stage and tumour response status were independent factors at multivariate analysis.

Conclusion

Texture features IV and SZV, and volumetric parameters MTV and TLG can predict tumour response, but all of them have limited value in prediction of prognosis of patients with esophageal cancer treated by CRT.
Appendix
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Metadata
Title
Texture analysis of 18F-FDG PET/CT to predict tumour response and prognosis of patients with esophageal cancer treated by chemoradiotherapy
Authors
Masatoyo Nakajo
Megumi Jinguji
Yoshiaki Nakabeppu
Masayuki Nakajo
Ryutarou Higashi
Yoshihiko Fukukura
Ken Sasaki
Yasuto Uchikado
Shoji Natsugoe
Takashi Yoshiura
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2017
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-016-3506-2

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