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Fig. 3 | EJNMMI Research

Fig. 3

From: Efficacy of 4′-[methyl-11C] thiothymidine PET/CT before and after neoadjuvant therapy for predicting therapeutic responses in patients with esophageal cancer: a pilot study

Fig. 3

A 68-year-old man with esophageal cancer treated by neoadjuvant chemoradiation therapy followed by esophagectomy. Baseline images (CT (a), FDG-PET/CT (b), and 4DST-PET/CT (c)). Post-neoadjuvant therapy images (CT (d), FDG-PET/CT (e), and 4DST-PET/CT (f)). Baseline chest CT showed esophageal cancer (a: arrow) in the upper thoracic region, and FDG and 4DST PET/CT demonstrated uptake into the primary lesion (b, c: arrow). Maximum standardized uptake value (SUVmax) of FDG and 4DST was 13.5 and 6.2, respectively. After neoadjuvant chemoradiation therapy, the tumor showed reduction in size (d: arrow). Post-therapeutic FDG-PET/CT demonstrated FDG-avid (SUVmax = 5.3) primary lesion (e: arrow) suggesting the possibility of inadequate response. In contrast, 4DST-PET/CT showed relatively low uptake (SUVmax = 2.5) into the tumor (f: arrow) indicating this patient was a responder. Subsequently, the patient underwent esophagectomy and pathologically confirmed as responder status (grade 2)

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