Evaluation of response to induction chemotherapy in esophageal cancer: Is barium esophagography or PET-CT useful? Journal Article


Authors: Eng, C. W.; Fuqua, J. L.; Grewal, R.; Ilson, D.; Messiah, A. C. D.; Rizk, N.; Tang, L.; Gollub, M. J.
Article Title: Evaluation of response to induction chemotherapy in esophageal cancer: Is barium esophagography or PET-CT useful?
Abstract: Objective: To determine whether sequential barium esophagograms can predict histopathological response to treatment in esophageal cancer. Materials and methods: Two radiologists retrospectively reviewed esophagograms pre- and post- chemotherapy in 32 patients for tumor length decrease of at least 15% and luminal width increase of at least 15%. Positron emission tomography-computed tomography (PET-CT) was reviewed for tumor maximum standardized uptake value (SUVmax) decrease of at least 35%. The reference standard was 90% or more tumor necrosis at histopathologic examination of the excised specimen. Results: Pathologic response ranged from 10% to 100% necrosis. For prediction of tumor response, the sensitivity, specificity, positive and negative predictive values for length ranged from 43.8 to 56.3% and for width from 41.2% to 66.7% and for SUVmax from 47.1% to 53.3%. Conclusion: Performance characteristics for barium esophagograms in our group of patients were similar to PET-CT in predicting tumor response. Both tests were inadequate in predicting tumor response. © 2013 Elsevier Inc.
Keywords: adult; clinical article; treatment outcome; treatment response; aged; retrospective studies; histopathology; cisplatin; chemotherapy; cancer staging; positron emission tomography; sensitivity and specificity; reproducibility of results; progression free survival; computer assisted tomography; multiple cycle treatment; phase 2 clinical trial; antineoplastic combined chemotherapy protocols; camptothecin; diagnostic imaging; retrospective study; irinotecan; computerized tomography; tumors; fluorodeoxyglucose f 18; remission induction; forecasting; contrast media; esophagus cancer; negative predictive value; diseases; esophageal neoplasms; predictive value; esophageal cancer; induction chemotherapy; fluoroscopy; diagnostic test accuracy study; pet-ct; barium; barium sulfate; pathologic response; positron-emission tomography and computed tomography; esophagography; barium esophagography; maximum standardized uptake values; performance characteristics; reference standard
Journal Title: Clinical Imaging
Volume: 37
Issue: 3
ISSN: 0899-7071
Publisher: Elsevier Inc.  
Date Published: 2013-05-01
Start Page: 468
End Page: 474
Language: English
DOI: 10.1016/j.clinimag.2012.08.003
PROVIDER: scopus
PUBMED: 23601767
DOI/URL:
Notes: --- - "Export Date: 3 June 2013" - "CODEN: CLIME" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Marc J Gollub
    106 Gollub
  2. Nabil Rizk
    134 Rizk
  3. Chee Way Eng
    1 Eng
  4. Ravinder K Grewal
    57 Grewal
  5. Laura Hong Tang
    320 Tang
  6. David H Ilson
    269 Ilson