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Association of dynamic contrast-enhanced MRI and 18 F-Fluorodeoxyglucose PET/CT parameters with neoadjuvant therapy response and survival in esophagogastric cancer.
- Source :
-
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2023 Oct; Vol. 49 (10), pp. 106934. Date of Electronic Publication: 2023 May 10. - Publication Year :
- 2023
-
Abstract
- Introduction: Better predictive markers are needed to deliver individualized care for patients with primary esophagogastric cancer. This exploratory study aimed to assess whether pre-treatment imaging parameters from dynamic contrast-enhanced MRI and <superscript>18</superscript> F-fluorodeoxyglucose ( <superscript>18</superscript> F-FDG) PET/CT are associated with response to neoadjuvant therapy or outcome.<br />Materials and Methods: Following ethical approval and informed consent, prospective participants underwent dynamic contrast-enhanced MRI and <superscript>18</superscript> F-FDG PET/CT prior to neoadjuvant chemotherapy/chemoradiotherapy ± surgery. Vascular dynamic contrast-enhanced MRI and metabolic <superscript>18</superscript> F-FDG PET parameters were compared by tumor characteristics using Mann Whitney U test and with pathological response (Mandard tumor regression grade), recurrence-free and overall survival using logistic regression modelling, adjusting for predefined clinical variables.<br />Results: 39 of 47 recruited participants (30 males; median age 65 years, IQR: 54, 72 years) were included in the final analysis. The tumor vascular-metabolic ratio was higher in patients remaining node positive following neoadjuvant therapy (median tumor peak enhancement/SUV <subscript>max</subscript> ratio: 0.052 vs. 0.023, p = 0.02). In multivariable analysis adjusted for age, gender, pre-treatment tumor and nodal stage, peak enhancement (highest gadolinium concentration value prior to contrast washout) was associated with pathological tumor regression grade. The odds of response decreased by 5% for each 0.01 unit increase (OR 0.95; 95% CI: 0.90, 1.00, p = 0.04). No <superscript>18</superscript> F-FDG PET/CT parameters were predictive of pathological tumor response. No relationships between pre-treatment imaging and survival were identified.<br />Conclusion: Pre-treatment esophagogastric tumor vascular and metabolic parameters may provide additional information in assessing response to neoadjuvant therapy.<br /> (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Subjects :
- Male
Humans
Aged
Fluorodeoxyglucose F18 therapeutic use
Positron Emission Tomography Computed Tomography methods
Neoadjuvant Therapy methods
Radiopharmaceuticals
Prospective Studies
Magnetic Resonance Imaging
Esophageal Neoplasms diagnostic imaging
Esophageal Neoplasms therapy
Esophageal Neoplasms metabolism
Stomach Neoplasms diagnostic imaging
Stomach Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2157
- Volume :
- 49
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 37183047
- Full Text :
- https://doi.org/10.1016/j.ejso.2023.05.009