Does pre-operative estimation of oesophageal tumour metabolic length using 18F-fluorodeoxyglucose PET/CT images compare with surgical pathology length?

  • Reubendra Jeganathan
  • James McGuigan
  • Frederick Campbell
  • Thomas Lynch
Original Article

Abstract

Purpose

The aim of the study was to compare the pre-operative metabolic tumour length on FDG PET/CT with the resected pathological specimen in patients with oesophageal cancer.

Methods

All patients diagnosed with oesophageal carcinoma who had undergone staging PET/CT imaging between the period of June 2002 and May 2008 who were then suitable for curative surgery, either with or without neo-adjuvant chemotherapy, were included in this study. Metabolic tumour length was assessed using both visual analysis and a maximum standardised uptake value (SUVmax) cutoff of 2.5.

Results

Thirty-nine patients proceeded directly to curative surgical resection, whereas 48 patients received neo-adjuvant chemotherapy, followed by curative surgery. The 95% limits of agreement in the surgical arm were more accurate when the metabolic tumour length was visually assessed with a mean difference of −0.05 cm (SD 2.16 cm) compared to a mean difference of +2.42 cm (SD 3.46 cm) when assessed with an SUVmax cutoff of 2.5. In the neo-adjuvant group, the 95% limits of agreement were once again more accurate when assessed visually with a mean difference of −0.6 cm (SD 1.84 cm) compared to a mean difference of +1.58 cm (SD 3.1 cm) when assessed with an SUVmax cutoff of 2.5.

Conclusion

This study confirms the high accuracy of PET/CT in measuring gross target volume (GTV) length. A visual method for GTV length measurement was demonstrated to be superior and more accurate than when using an SUVmax cutoff of 2.5. This has the potential of reducing the planning target volume with dose escalation to the tumour with a corresponding reduction in normal tissue complication probability.

Keywords

Oesophageal cancer Tumour length PET/CT Radiotherapy planning 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Reubendra Jeganathan
    • 1
    • 4
  • James McGuigan
    • 1
  • Frederick Campbell
    • 2
  • Thomas Lynch
    • 3
  1. 1.Regional Thoracic Surgical UnitRoyal Victoria HospitalBelfastUK
  2. 2.Centre for Cancer Research & Cell BiologyBelfastUK
  3. 3.Northern Ireland Cancer CentreBelfast City HospitalBelfastUK
  4. 4.Cardiothoracic Surgery, Ground Floor West WingRoyal Victoria HospitalBelfastUK

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