The relationship between FDG PET/CT-defined metabolic parameters and the histopathological subtype of oesophageal carcinomas

Abstract

Purpose: 18F-fluorodeoxyglucose (18 F-FDG) positron emission tomography (PET) combined with computed tomography (CT) scan is accepted as a standard tool in the staging of oesophageal cancer (OC). Histological subtype of tumour is known to be a major determinant of prognosis and metabolic behaviour. In this study, we aimed to evaluate the effect of histological subtypes of OC on standard uptake value (SUV max), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) obtained by PET/CT, and also to compare this effect with prognosis. Material and methods: Images and clinical course data of 57 patients who were diagnosed with EC and treated in our hospital between 2009 and 2016 were evaluated in a retrospective manner. PET/CT images were re-analysed in terms of metabolic parameters, and observations were compared with histological subtypes. Results: No significant difference was observed between histological subtypes with SUV max , overall survival (OS), or progression-free survival (PFS). Thus, MTV was observed to be related with histological subtype; MTV values of adenocancer patients were significantly higher than those of squamous cell cancer patients. Conclusions: Metabolic tumour volume was related with histological subtype of OC, but clinical staging, TLG, and SUV max values were not related with histological subtype, which may suggest the use of MTV as a routine parameter for OC and inclusion of MTV observations in prognostic scoring.

Volumetric Evaluation of Staging ¹⁸F-FDG PET/CT Images in Patients with Esophageal Cancer

“…Also, the discrimination of histopathological subtypes of EC is impossible with current imaging modalities. One study suggested that SUV max was not related to histopathological subtypes of EC but, MTV values of AC patients were significantly higher than those of SCC patients ( 10 ). However, there are also studies, which could not determine histopathological subtypes with SUV max or MTV ( 11 ).…”

Can 18F-FDG PET/CT Radiomics Features Predict Clinical Outcomes in Patients with Locally Advanced Esophageal Squamous Cell Carcinoma?

“…It has been shown to provide valuable prognostic information prior to any treatment and during and after chemoradiotherapy [ 2 , 3 ]. Correlations between prognosis and various metabolic parameters such as standardized uptake value, total lesion glycolysis, and metabolic tumor volume have been reported in several studies [ 4 , 5 , 6 , 7 ]. Radiomics analysis allows us to use the diagnostic images further by extracting information otherwise “invisible” to the naked eye and thus potentially improve the diagnostic and prognostic accuracy of a given study [ 8 , 9 ].…”

Relationship between 18F-FDG PET/CT Semi-Quantitative Parameters and International Association for the Study of Lung Cancer, American Thoracic Society/European Respiratory Society Classification in Lung Adenocarcinomas

“…Alternative quantitative metrics that consider not only SUVmax but also tracer uptake throughout the entire lesion have been proposed, such as metabolic tumor volume (MTV), which is defined as the total number of voxels within a volume of interest that have uptake above a predetermined SUV threshold, and total lesion glycolysis (TLG), calculated as MTV × SUVmean. Recent studies have identified volumetric parameters (MTV and TLG) as significant independent variables in predicting histological subtypes of esophageal cancer and other tumors [ 13 14 15 ]. However, MTV or TLG do not consider background activity; therefore, they are not accurate enough to delineate the boundaries of spatial heterogeneity intratumor or metabolically active tumor volume, especially for ground-glass nodules (GGN).…”