Evaluation of the Prognostic Value of Quantitative and Visual Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG PET/CT) Parameters in Superficial Esophageal Squamous Cell Carcinoma

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INTRODUCTION: Early diagnosis is crucial for improving outcomes in esophageal cancer, as prognosis is strongly dependent on the stage at detection. This study evaluated the prognostic value of quantitative and visual 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) parameters in patients with superficial esophageal squamous cell carcinoma (SESCC). MATERIALS AND METHODS: A retrospective cohort of 95 patients with clinically confirmed SESCC who underwent pre-treatment FDG PET/CT was analyzed. Patients were stratified into FDG-positive and FDG-negative groups using both visual assessment and quantitative thresholds. Quantitative parameters included maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Associations with overall survival and pathological TNM classification were assessed. RESULTS: Quantitative analysis using SUVmax (threshold = 3.0) demonstrated significant prognostic stratification, with FDG-negative patients exhibiting superior overall survival compared to FDG-positive patients (p = 0.0264, log-rank test). Visual assessment did not yield significant survival discrimination (p = 0.3222). No significant correlations were identified between FDG-derived parameters and pathological or clinical TNM stages. CONCLUSION: Quantitative FDG PET/CT parameters, particularly SUVmax, provide superior prognostic information compared to visual assessment in SESCC. Incorporating quantitative metabolic imaging into the initial evaluation of early-stage esophageal cancer may enhance risk stratification and inform treatment planning.

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