Using positron-emission tomography–computed tomography for predicting radiotherapy-induced tumor regression in carcinoma esophagus in an Indian population

Sankalp Singh; Niharika Bisht; Arti Sarin; A. V. S. Kumar; Samir Gupta; Amul Kapoor; Prabha Mishra

doi:10.4103/wjnm.WJNM_114_18

World Journal of Nuclear Medicine, Table of Contents

CC BY-NC-ND 4.0 · World J Nucl Med 2019; 18(04): 361-365
DOI: 10.4103/wjnm.WJNM_114_18

Original Article

Using positron-emission tomography–computed tomography for predicting radiotherapy-induced tumor regression in carcinoma esophagus in an Indian population

Sankalp Singh

Department of Radiation Oncology, Command Hospital (CC), Lucknow, Uttar Pradesh, India

,

Niharika Bisht

¹Department of Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India

,

Arti Sarin

¹Department of Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India

,

A. V. S. Kumar

²Department of Nuclear Medicine, Command Hospital (SC), Pune, Maharashtra, India

,

Samir Gupta

¹Department of Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India

,

Amul Kapoor

¹Department of Malignant Disease Treatment Centre, Command Hospital (SC), Pune, Maharashtra, India

,

Prabha Mishra

³Department of Pathology, Command Hospital (SC), Pune, Maharashtra, India

› Author Affiliations

Abstract

Carcinoma esophagus is a common malignancy of the Indian subcontinent. The role of positron-emission tomography–computed tomography (PET-CT) in the assessment of response to radiotherapy has been widely studied and accepted. However, its precise use as a predictive tool for actual histopathological response to radiotherapy needs further evaluation, especially in an Indian population. The aim of this study was to identify a quantum of metabolic response on PET-CT that can also predict for a good pathological response. Forty-four patients of carcinoma esophagus treated with neoadjuvant chemoradiotherapy followed by surgery were included in the study. All patients underwent a PET-CT before starting treatment as well as at 4–6 weeks after completion of radiotherapy. The percentage change in pre and posttreatment maximum standardized uptake value (SUV_max) value (ΔSUV%) of the primary tumor was correlated against histopathological tumor regression grade (TRG) as per the Mandard's system. Seventy-five percent of the patients with a significant metabolic response, i.e., a ΔSUV% of 60% or more, also had a good pathological response to treatment. Thus, by considering a ΔSUV% of 60%, we could predict for a good pathological response (TRG of 1 or 2) to chemoradiotherapy in our patient set with a sensitivity of 95.45% and a specificity of 72.72%.

Keywords

Carcinoma esophagus - positron-emission tomography–computed tomography - radiotherapy

Full Text

References

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