Tumor heterogeneity assessed in [¹⁸F]FDG PET/CT may help to predict patients outcome in oesophageal cancer patients

The aim of this study was to estimate value of several heterogeneity parameters assessed in [¹⁸F]FDG PET/CT study in prediction outcome in oesophageal cancer patients.

Retrospective analysis was performed on a group of 98 (79 M, 19 F) previously untreated oesophageal cancer patients, who underwent the [¹⁸F]FDG PET/CT study to assess the severity of the disease. Several heterogeneity parameters: skewness, kurtosis, coefficient of variation (COV), heterogeneity index (HI) and heterogeneity factor (HF) were extracted form images and used to estimate outcome in oespohageal cancer patients. Additionally, patients were analyzed in terms of histopathology (squamous cell carcinoma– ESCC and adenocarcinoma– EAC).

In the whole analyzed group COV significantly correlated with recurrence (p = 0.0491) and overall survival (p = 0.0184) while HI and HF were significantly associated with overall survival (p = 0.0364 and p = 0.0451, respectively). In terms of ESCC group from all assessed parameters only HF was significantly associated with overall survival (p = 0.0495), while in EAC group only COV was significant for overall survival (p = 0.0188). In terms of using heterogeneity factors for discrimination histopathological type statistically significant differences were shown in kurtosis (p = 0.0005) and COV (p = 0.0347).

Heterogeneity parameters obtained from [¹⁸F]FDG PET study significantly differ between histopathological types of oesophageal cancer patients, and choosing an appropriate parameters can help predict survival in these patients.