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Early response evaluation of neoadjuvant therapy with PET/MRI to predict resectability in patients with adenocarcinoma of the esophagogastric junction

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@article{a0961bee98454309b492e5005c9563bf,
title = "Early response evaluation of neoadjuvant therapy with PET/MRI to predict resectability in patients with adenocarcinoma of the esophagogastric junction",
abstract = "STUDY DESIGN AND PURPOSE: Positron emission tomography (PET)/magnetic resonance imaging (MRI) is a new modality that has showed promising results for various clinical indications. Currently, evaluation of neoadjuvant therapy (NT) among patients with adenocarcinoma of the esophagogastric junction has primarily been reserved for PET/computed tomography. Our aim was to evaluate if early response evaluation by PET/MRI is a feasible method to predict resectability.METHODS AND MATERIALS: Patients with untreated adenocarcinoma of the esophagogastric junction (Siewert types I/II) and fit for NT with no contraindications for PET/MRI were considered eligible. A baseline scan was performed prior to NT induction and an evaluation scan 3 weeks later. For histopathological response evaluation, the Mandard tumor regression grade score was applied. Response on PET/MRI was evaluated with Response Evaluation Criteria in Solid Tumors (RECIST 1.1), and change in ADC and SUVmax values.RESULTS: Twenty-eight patients were enrolled, and 22 completed both scans and proceeded to final analyses. Seventeen patients were found resectable versus five who were found unresectable. PET/MRI response evaluation had a sensitivity 94{\%}, specificity 80{\%}, and AUC = 0.95 when predicting resectability in patients with adenocarcinoma of the esophagogastric junction. No association with histopathological response (tumor regression grade) was found nor was RECIST correlated with resectability.CONCLUSION: Response evaluation using PET/MRI was a feasible method to predict resectability in patients with adenocarcinoma of the esophagogastric junction in this pilot study. However, larger studies are warranted to justify the use of the modality for this indication.",
keywords = "Chemotherapy, Gastroesophageal junction cancer, Magnetic resonance imaging, Positron emission tomography, Resectability, Response evaluation",
author = "Mohamed Belmouhand and Johan L{\"o}fgren and Johannesen, {Helle Hjorth} and Lene Baeksgaard and Henrik Gutte and Kiran Tariq and Achiam, {Michael Patrick}",
year = "2019",
month = "3",
doi = "10.1007/s00261-018-1841-4",
language = "English",
volume = "44",
pages = "836--844",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer",
number = "3",

}

RIS

TY - JOUR

T1 - Early response evaluation of neoadjuvant therapy with PET/MRI to predict resectability in patients with adenocarcinoma of the esophagogastric junction

AU - Belmouhand, Mohamed

AU - Löfgren, Johan

AU - Johannesen, Helle Hjorth

AU - Baeksgaard, Lene

AU - Gutte, Henrik

AU - Tariq, Kiran

AU - Achiam, Michael Patrick

PY - 2019/3

Y1 - 2019/3

N2 - STUDY DESIGN AND PURPOSE: Positron emission tomography (PET)/magnetic resonance imaging (MRI) is a new modality that has showed promising results for various clinical indications. Currently, evaluation of neoadjuvant therapy (NT) among patients with adenocarcinoma of the esophagogastric junction has primarily been reserved for PET/computed tomography. Our aim was to evaluate if early response evaluation by PET/MRI is a feasible method to predict resectability.METHODS AND MATERIALS: Patients with untreated adenocarcinoma of the esophagogastric junction (Siewert types I/II) and fit for NT with no contraindications for PET/MRI were considered eligible. A baseline scan was performed prior to NT induction and an evaluation scan 3 weeks later. For histopathological response evaluation, the Mandard tumor regression grade score was applied. Response on PET/MRI was evaluated with Response Evaluation Criteria in Solid Tumors (RECIST 1.1), and change in ADC and SUVmax values.RESULTS: Twenty-eight patients were enrolled, and 22 completed both scans and proceeded to final analyses. Seventeen patients were found resectable versus five who were found unresectable. PET/MRI response evaluation had a sensitivity 94%, specificity 80%, and AUC = 0.95 when predicting resectability in patients with adenocarcinoma of the esophagogastric junction. No association with histopathological response (tumor regression grade) was found nor was RECIST correlated with resectability.CONCLUSION: Response evaluation using PET/MRI was a feasible method to predict resectability in patients with adenocarcinoma of the esophagogastric junction in this pilot study. However, larger studies are warranted to justify the use of the modality for this indication.

AB - STUDY DESIGN AND PURPOSE: Positron emission tomography (PET)/magnetic resonance imaging (MRI) is a new modality that has showed promising results for various clinical indications. Currently, evaluation of neoadjuvant therapy (NT) among patients with adenocarcinoma of the esophagogastric junction has primarily been reserved for PET/computed tomography. Our aim was to evaluate if early response evaluation by PET/MRI is a feasible method to predict resectability.METHODS AND MATERIALS: Patients with untreated adenocarcinoma of the esophagogastric junction (Siewert types I/II) and fit for NT with no contraindications for PET/MRI were considered eligible. A baseline scan was performed prior to NT induction and an evaluation scan 3 weeks later. For histopathological response evaluation, the Mandard tumor regression grade score was applied. Response on PET/MRI was evaluated with Response Evaluation Criteria in Solid Tumors (RECIST 1.1), and change in ADC and SUVmax values.RESULTS: Twenty-eight patients were enrolled, and 22 completed both scans and proceeded to final analyses. Seventeen patients were found resectable versus five who were found unresectable. PET/MRI response evaluation had a sensitivity 94%, specificity 80%, and AUC = 0.95 when predicting resectability in patients with adenocarcinoma of the esophagogastric junction. No association with histopathological response (tumor regression grade) was found nor was RECIST correlated with resectability.CONCLUSION: Response evaluation using PET/MRI was a feasible method to predict resectability in patients with adenocarcinoma of the esophagogastric junction in this pilot study. However, larger studies are warranted to justify the use of the modality for this indication.

KW - Chemotherapy

KW - Gastroesophageal junction cancer

KW - Magnetic resonance imaging

KW - Positron emission tomography

KW - Resectability

KW - Response evaluation

UR - http://www.scopus.com/inward/record.url?scp=85056849048&partnerID=8YFLogxK

U2 - 10.1007/s00261-018-1841-4

DO - 10.1007/s00261-018-1841-4

M3 - Journal article

VL - 44

SP - 836

EP - 844

JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

IS - 3

ER -

ID: 56602032