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Article: Timing and intensity of changes in FDG uptake with symptomatic esophagitis during radiotherapy or chemo-radiotherapy

TitleTiming and intensity of changes in FDG uptake with symptomatic esophagitis during radiotherapy or chemo-radiotherapy
Authors
KeywordsRadiation esophagitis
Non-small cell lung cancer
FDG PET
Standard uptake value (SUV)
Issue Date2014
Citation
Radiation Oncology, 2014, v. 9, n. 1, article no. 37 How to Cite?
AbstractPurpose: To study whether esophageal FDG activity changes by time of mid-course of fractionated radiotherapy (RT), and whether these changes are associated with radiation esophagitis in patients with non-small cell lung cancer (NSCLC).Methods: Fifty patients with stage I-III NSCLC were enrolled prospectively and, all received ≥60 Gy RT. FDG-PET/CT scans were acquired prior to, and during-RT after delivery of 45 Gy. Normalized standardized uptake values (NSUV), defined by the esophageal maximum SUV relative to intravascular background level in the aortic arch, were sampled in the esophagus at the level of the primary tumor, sternal notch, aortic arch, carina, and gastro-esophageal junction. Symptomatic radiation esophagitis was defined as an event.Results: Compared to baseline, esophageal NSUV increased significantly during-RT at the level of the primary tumor (1.09 ± 0.05 vs.1.28 ± 0.06, p = 0.001), but did not change at other levels in the esophagus. 16 patients had radiation esophagitis events and these patients had significantly higher during-RT to baseline NSUV ratios than those without esophagitis (1.46 ± 0.12, 95% CI 1.20-1.71; vs. 1.11 ± 0.05, 95% CI 1.01-1.21, p = 0.002). Maximum esophageal dose (p = 0.029), concurrent chemotherapy (p = 0.022) and esophageal FDG PET NSUV ratio (during-RT to baseline, p = 0.007), were independent factors associated with esophagitis and area under curves (AUC) were 0.76, 0.70 and 0.78, respectively. Combining esophageal maximum dose and FDG PET NSUV Ratio at the tumor level increased AUC to 0.85 (p = 0.016).Conclusion: FDG uptake increased in esophagus during-RT and this increase may predict radiation esphagitis during later course of treatment. © 2014 Yuan et al.; licensee BioMed Central Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/266980
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYuan, Shuanghu T.-
dc.contributor.authorBrown, Richard K.J.-
dc.contributor.authorZhao, Lujun-
dc.contributor.authorTen Haken, Randall K.-
dc.contributor.authorGross, Milton-
dc.contributor.authorCease, Kemp B.-
dc.contributor.authorSchipper, Matt-
dc.contributor.authorStanton, Paul-
dc.contributor.authorYu, Jinming-
dc.contributor.authorKong, Feng Ming S.-
dc.date.accessioned2019-01-31T07:20:09Z-
dc.date.available2019-01-31T07:20:09Z-
dc.date.issued2014-
dc.identifier.citationRadiation Oncology, 2014, v. 9, n. 1, article no. 37-
dc.identifier.urihttp://hdl.handle.net/10722/266980-
dc.description.abstractPurpose: To study whether esophageal FDG activity changes by time of mid-course of fractionated radiotherapy (RT), and whether these changes are associated with radiation esophagitis in patients with non-small cell lung cancer (NSCLC).Methods: Fifty patients with stage I-III NSCLC were enrolled prospectively and, all received ≥60 Gy RT. FDG-PET/CT scans were acquired prior to, and during-RT after delivery of 45 Gy. Normalized standardized uptake values (NSUV), defined by the esophageal maximum SUV relative to intravascular background level in the aortic arch, were sampled in the esophagus at the level of the primary tumor, sternal notch, aortic arch, carina, and gastro-esophageal junction. Symptomatic radiation esophagitis was defined as an event.Results: Compared to baseline, esophageal NSUV increased significantly during-RT at the level of the primary tumor (1.09 ± 0.05 vs.1.28 ± 0.06, p = 0.001), but did not change at other levels in the esophagus. 16 patients had radiation esophagitis events and these patients had significantly higher during-RT to baseline NSUV ratios than those without esophagitis (1.46 ± 0.12, 95% CI 1.20-1.71; vs. 1.11 ± 0.05, 95% CI 1.01-1.21, p = 0.002). Maximum esophageal dose (p = 0.029), concurrent chemotherapy (p = 0.022) and esophageal FDG PET NSUV ratio (during-RT to baseline, p = 0.007), were independent factors associated with esophagitis and area under curves (AUC) were 0.76, 0.70 and 0.78, respectively. Combining esophageal maximum dose and FDG PET NSUV Ratio at the tumor level increased AUC to 0.85 (p = 0.016).Conclusion: FDG uptake increased in esophagus during-RT and this increase may predict radiation esphagitis during later course of treatment. © 2014 Yuan et al.; licensee BioMed Central Ltd.-
dc.languageeng-
dc.relation.ispartofRadiation Oncology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectRadiation esophagitis-
dc.subjectNon-small cell lung cancer-
dc.subjectFDG PET-
dc.subjectStandard uptake value (SUV)-
dc.titleTiming and intensity of changes in FDG uptake with symptomatic esophagitis during radiotherapy or chemo-radiotherapy-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/1748-717X-9-37-
dc.identifier.pmid24467939-
dc.identifier.scopuseid_2-s2.0-84899134675-
dc.identifier.volume9-
dc.identifier.issue1-
dc.identifier.spagearticle no. 37-
dc.identifier.epagearticle no. 37-
dc.identifier.eissn1748-717X-
dc.identifier.isiWOS:000209614400001-

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