Correlation between semiquantitative and quantitative [18F]FDG PET/CT parameters and serum tumor marker levels in recurrent esophageal carcinoma: up to 12-year follow-up study.

BACKGROUND

This study investigated the correlation between semiquantitative and quantitative [¹⁸F]fluorodeoxyglucose positron emission tomography/computed tomography ([¹⁸F]FDG PET/CT) parameters of locoregional and metastatic lesions and serum tumor marker levels in esophageal carcinoma (EC). Secondary aims were to compare the diagnostic performance of CT and [¹⁸F]FDG PET/CT and to identify predictors of progression-free survival (PFS) and overall survival (OS).

MATERIAL AND

METHODS

This retrospective cohort study included 101 patients with EC with suspected local recurrence or metastases. Serum tumor marker levels - carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), carbohydrate antigen 72-4 (CA 72-4) - and CT findings were available within one and three months prior to [¹⁸F]FDG PET/CT, respectively.

RESULTS

[¹⁸F]FDG PET/CT was positive in 77/101 patients (76.2%), detecting locoregional lesions in 45 and metastases in 67 patients. Weak positive correlations were found between CEA levels and standardized uptake value peak (SUVpeak) (ρ = 0.283, p = 0.020) and metabolic tumor volume (MTV) of metastatic lesions (ρ = 0.259, p = 0.034). Moderate positive correlations were observed with SUVmax (ρ = 0.302, p = 0.013) and SUVmean (ρ = 0.325, p = 0.007) of metastatic lesions. [¹⁸F]FDG PET/CT demonstrated superior diagnostic performance compared with CT. Tumor grade, middle-third location, prior radiotherapy, [¹⁸F]FDG PET/CT and CT findings, and CEA and CA 72-4 levels were identified as potential predictors of PFS and OS.

CONCLUSIONS

Over 12 years, we demonstrated a direct correlation between serum CEA levels and metabolic [¹⁸F]FDG PET/CT parameters of metastatic lesions in EC.