Abstract
The purpose of this study was to prospectively evaluate the predictive value of perfusion computed tomography (CT) for response of local advanced esophageal carcinoma to radiotherapy and chemotherapy. Before any treatment, forty-three local advanced esophageal squamous cell carcinomas were prospectively evaluated by perfusion scan with 16-row CT from June 2009 to January 2012. Perfusion parameters, including perfusion (BF), peak enhanced density (PED), blood volume (BV), and time to peak (TTP) were measured using Philips perfusion software. Seventeen cases received definitive radiotherapy and 26 received concurrent chemo-radiotherapy. The response was evaluated by CT scan and esophagography. Differences in perfusion parameters between responders and non-responders were analyzed, and ROCs were used to assess predictive value of the baseline parameters for treatment response. There were 25 responders (R) and 18 non-responders (NR). Responders showed significantly higher BF (R:34.1 ml/100 g/min vs NR: 25.0 ml/100 g/min, p=0.001), BV (23.2 ml/100g vs 18.3 ml/100g, p=0.009) and PED (32.5 HU vs 28.32 HU, P=0.003) than non-responders. But the baseline TTP (R: 38.2 s vs NR: 44.10 s, p=0.172) had no difference in the two groups. For baseline BF, a threshold of 36.1 ml/100 g/min achieved a sensitivity of 56%, and a specificity of 94.4% for detection of clinical responders from non-responders. The results suggest that the perfusion CT can provide some helpful information for identifying tumors that may respond to radio-chemotherapy.
Highlights
Esophageal cancer is one of the most deadly cancers with a rapidly rising incidence
We examined the usefulness of perfusion computed tomography (CT) on predicting of response in patients with local advanced esophageal squamous cell carcinoma who received radiation and chemotherapy
Our study suggested that perfusion CT can provide some helpful information for the prediction of the response and survival
Summary
More than 50% of esophageal cancers are diagnosed at locally advanced stages, which are generally treated using multimodal therapies. For esophageal cancer, we do not have good markers to predict response to therapy and avoid any time delay in non-responders. The purpose of this study was to prospectively evaluate the predictive value of perfusion computed tomography (CT) for response of local advanced esophageal carcinoma to radiotherapy and chemotherapy. Materials and Methods: Before any treatment, forty-three local advanced esophageal squamous cell carcinomas were prospectively evaluated by perfusion scan with 16-row CT from June 2009 to January 2012. Differences in perfusion parameters between responders and non-responders were analyzed, and ROCs were used to assess predictive value of the baseline parameters for treatment response. Conclusions: The results suggest that the perfusion CT can provide some helpful information for identifying tumors that may respond to radio-chemotherapy
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