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

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.