Prognostic value of 18F-FDG PET/MR imaging biomarkers in oesophageal squamous cell carcinoma.Eur J Radiol 2019; 120:108671EJ
To correlate the clinical stage and prognosis of oesophageal squamous cell carcinoma (SCC) using the imaging biomarkers from integrated positron emission tomography (PET)/magnetic resonance imaging (MRI).
In total, 54 consecutive patients with oesophageal SCC who receive PET/MRI scan were recruited before treatment. The imaging biomarkers used were the mean and minimal apparent diffusion coefficients (ADCmean and ADCmin), standardized uptake value (SUV), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) of tumours. The correlation between each imaging biomarker and survival was investigated using the Cox proportional hazards model.
ADCmean was negatively correlated with SUVmax (r = -0.414, P = 0.025). ADCmin was negatively correlated with SUVmax (r = -0.423, P = 0.001) and SUVpeak (r = -0.402, P = 0.003), and was significantly lower in M1 than in M0 tumours (829.6 vs. 1069.8, P = 0.005). MTV was significantly higher in T3 + (P < 0.001), N1 + (P = 0.014) and TNM stage III + (P < 0.001) tumours. TLG was significantly higher in T3 + (P < 0.001), N1 + (P < 0.001), M1 (P = 0.045) and TNM stage III + (P < 0.001) tumours. The MTV/ADCmin ratio exhibited the highest area under the receiver operating characteristic curve (AUROC) for predicting M1 and advanced TNM stage tumours. Multivariate analysis for progression-free survival (PFS) and overall survival (OS) showed that a larger MTV/ADCmin was associated with a shorter PFS and OS (P = 0.024 and 0.046, respectively).
The imaging biomarkers in integrated PET/MRI may predict clinical stage and survival in patients with oesophageal SCC.