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Preoperative Chemo-Radiation-Induced Ulceration in Patients with Esophageal Cancer: A Confounding Factor in Tumor Response Assessment in Integrated Computed.

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Presentation on theme: "Preoperative Chemo-Radiation-Induced Ulceration in Patients with Esophageal Cancer: A Confounding Factor in Tumor Response Assessment in Integrated Computed."— Presentation transcript:

1 Preoperative Chemo-Radiation-Induced Ulceration in Patients with Esophageal Cancer: A Confounding Factor in Tumor Response Assessment in Integrated Computed Tomographic-Positron Emission Tomographic Imaging  Jeremy J. Erasmus, MD, Reginald F. Munden, DMD, MD, Mylene T. Truong, MD, Jeremy J. Ho, BSc, Wayne L. Hofstetter, MD, Homer A. Macapinlac, MD, Arlene M. Correa, PhD, Tsung-Teh Wu, MD, John F. Bruzzi, MD, Edith M. Marom, MD, Bradley S. Sabloff, MD, Jaffer A. Ajani, MD, Ritsuko Komaki, MD, Zhongxing Liao, MD, Jeffrey H. Lee, MD, Norio Fukami, MD, Robert Bresalier, MD, Stephen G. Swisher, MD  Journal of Thoracic Oncology  Volume 1, Issue 5, Pages (June 2006) DOI: /S (15) Copyright © 2006 International Association for the Study of Lung Cancer Terms and Conditions

2 FIGURE 1 A, Sagittal CT. B, PET. C, Integrated CT-PET. Diffuse uptake of [18F]-fluoro-2-deoxy-D-glucose in the treated esophagus with SUV 8.7 in the region of the primary malignancy. Endoscopy/EUS showed absence of esophagitis and ulceration. CT-PET in combination with endoscopy/EUS was interpreted as therapeutic failure. At resection, histopathology confirmed >50% viable tumor. Journal of Thoracic Oncology 2006 1, DOI: ( /S (15) ) Copyright © 2006 International Association for the Study of Lung Cancer Terms and Conditions

3 FIGURE 2 A, Coronal CT. B, PET. C, Integrated CT-PET. Focal increased [18F]-fluoro-2-deoxy-D-glucose uptake in the region of the esophageal malignancy SUV 6.5. Endoscopy/EUS showed esophagitis and ulceration. CT-PET in combination with endoscopy/EUS was interpreted as response to therapy. At resection, histopathology revealed complete response with 0% viable tumor. Journal of Thoracic Oncology 2006 1, DOI: ( /S (15) ) Copyright © 2006 International Association for the Study of Lung Cancer Terms and Conditions

4 FIGURE 3 A, Axial CT. B, PET. C, Integrated CT-PET. Absence of [18F]-fluoro-2-deoxy-D-glucose uptake in the treated esophagus. CT-PET was interpreted as response to therapy. At resection, histopathology revealed partial response with 20% viable tumor. CT-PET is unable to detect residual microscopic disease after CRT. Journal of Thoracic Oncology 2006 1, DOI: ( /S (15) ) Copyright © 2006 International Association for the Study of Lung Cancer Terms and Conditions

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