Clinical value of multiparameters of 2-[ 18 F]-fluoro-2-deoxy-glucose PET/MRI in tumor/lymph node staging of esophageal squamous cell carcinoma.

Abstract

Purpose: We aimed to determine the role of integrated 2-[ 18 F]-fluoro-2-deoxy-glucose ( 18 F-FDG) PET/MRI in preoperative T and N staging and prognosis of esophageal squamous cell carcinoma (ESCC).

Materials and methods: The analysis was conducted on 66 ESCC patients who accepted 18 F-FDG-PET/MRI examinations per-operatively. We select the primary lesion as the region of interest to evaluate the diagnostic efficiency of T and N staging. Univariate and stepwise multivariate logistic regression models were performed to determine the T and N staging factors, and we established the optimal prediction model by using the Akaike information criterion. Finally, Cox regression was used for the early recurrence analyses.

Results: The total lesion glycolysis (TLG), metabolic tumor volume (MTV), minimum apparent diffusion coefficient (ADC min ), and mean apparent diffusion coefficient (ADC mean ) were significant in univariate analysis with T staging. None of the parameters were significant in the univariate analysis with N staging. Cox regression validated that this model-combining TLG (>47.5), MTV (>9.4 cm 3 ), ADC min (<1.49 × 10 -3 mm 2 /s), and ADC mean (<1.68 × 10 -3 mm 2 /s)-was the sole predictor significant associated with early tumor recurrence. Notably, no association was found between any single variable and early tumor recurrence.

Conclusion: Integrated 18 F-FDG PET/MRI is feasible for preoperative T and N staging of ESCC. The optimal model is composed of TLG, MTV, ADC min, and ADC mean -all parameters derived from 18 F-FDG-PET/MRI-which not only provide valuable information for T staging but also predict early recurrence within the first postoperative year.