Estimation of esophageal involvement length in esophagogastric junction tumors using PET-CT

Nagano, Shinnosuke; Kurokawa, Yukinori; Hagi, Takaomi; Saito, Takuro; Takahashi, Tsuyoshi; Nakai, Shigeto; Momose, Kota; Yamashita, Kotaro; Tanaka, Koji; Makino, Tomoki; Nakajima, Kiyokazu; Eguchi, Hidetoshi; Doki, Yuichiro

doi:https://doi.org/10.1007/s10388-026-01183-6

Estimation of esophageal involvement length in esophagogastric junction tumors using PET-CT

Nagano, Shinnosuke; Kurokawa, Yukinori; Hagi, Takaomi et al.

Esophagus, 2026

Number of Access:81（2026-06-02 04:51 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/104236

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Title	Estimation of esophageal involvement length in esophagogastric junction tumors using PET-CT
Creator	ORCID 0009-0007-9127-3184 0009-0007-9127-3184 Scopus Author ID 57220174489 57220174489 CreatorName Nagano, Shinnosuke
	NRID 1000010470197 1000010470197 ORCID 0000-0002-2883-0132 0000-0002-2883-0132 researchmap permalink krkw krkw Scopus Author ID 7202562410 7202562410 CreatorName Kurokawa, Yukinori
	NRID 1000050804465 1000050804465 ORCID 0000-0002-4028-2714 0000-0002-4028-2714 researchmap permalink thagi thagi Scopus Author ID 57209822096 57209822096 CreatorName Hagi, Takaomi
	NRID 1000020646468 1000020646468 ORCID 0000-0002-1733-5064 0000-0002-1733-5064 researchmap permalink tsaito19 tsaito19 Scopus Author ID 57211629912 57211629912 CreatorName Saito, Takuro
	NRID 1000050452389 1000050452389 ORCID 0000-0003-2397-1478 0000-0003-2397-1478 researchmap permalink mihogaoka13611 mihogaoka13611 Scopus Author ID 56182761100 56182761100 CreatorName Takahashi, Tsuyoshi
	NRID 1000040912027 1000040912027 ORCID 0009-0002-8713-9365 0009-0002-8713-9365 Scopus Author ID 57201910767 57201910767 CreatorName Nakai, Shigeto
	NRID 1000050749752 1000050749752 ORCID 0009-0004-2623-2122 0009-0004-2623-2122 researchmap permalink kom2005 kom2005 Scopus Author ID 59711925000 59711925000 CreatorName Momose, Kota
	NRID 1000020747159 1000020747159 researchmap permalink k-yamashita k-yamashita Scopus Author ID 57191498316 57191498316 CreatorName Yamashita, Kotaro
	NRID 1000070621019 1000070621019 ORCID 0000-0001-5178-9388 0000-0001-5178-9388 researchmap permalink koji_tanaka koji_tanaka Scopus Author ID 55628548952 55628548952 CreatorName Tanaka, Koji
	NRID 1000080528620 1000080528620 ORCID 0000-0001-7918-4217 0000-0001-7918-4217 researchmap permalink _-_-_- _-_-_- Scopus Author ID 56339970700 56339970700 CreatorName Makino, Tomoki
	NRID 1000030432537 1000030432537 ORCID 0000-0001-8635-7585 0000-0001-8635-7585 researchmap permalink project_engine project_engine Scopus Author ID 7404396263 7404396263 CreatorName Nakajima, Kiyokazu
	NRID 1000090542118 1000090542118 ORCID 0000-0002-2318-1129 0000-0002-2318-1129 researchmap permalink abcdabcdabcd abcdabcdabcd Scopus Author ID 7101627772 7101627772 CreatorName Eguchi, Hidetoshi
	NRID 1000020291445 1000020291445 researchmap permalink ydoki3251 ydoki3251 Scopus Author ID 7006390687 7006390687 CreatorName Doki, Yuichiro
Subject	Esophageal involvement length
	Esophagogastric junction tumors
	PET-CT
	Proximal tumor margin
	Vena cava foramen
Description	Nagano S., Kurokawa Y., Hagi T., et al. Estimation of esophageal involvement length in esophagogastric junction tumors using PET-CT. Esophagus (2026); https://doi.org/10.1007/s10388-026-01183-6.
Abstract	Background: Esophageal involvement length (EIL) is crucial to determining the surgical strategy for esophagogastric junction (EGJ) tumors. This study developed a positron emission tomography–computed tomography (PET-CT)-based method using anatomical landmarks to estimate EIL and evaluated the clinical utility of the model. Methods: We enrolled 50 patients with EGJ adenocarcinoma who underwent surgical resection. Among patients who underwent upfront surgery (Cohort 1, n = 24), craniocaudal distances were measured from the right and left diaphragms and vena cava foramen (VCF) to the proximal tumor margin on PET-CT images and correlated with histological EIL to establish the best-performing model. Predictive ability was validated in patients who underwent surgery after neoadjuvant chemotherapy (Cohort 2, n = 26). Results: In Cohort 1, among the three anatomical landmarks, VCF most strongly correlated with histological EIL (r = 0.81), providing the following formula: Predicted EIL (mm) = 22 + 0.3 × [Craniocaudal distance from VCF to proximal tumor margin (mm)]. The median absolute difference between the histological and predicted EILs was 4.6 mm (interquartile range, 1.6–6.3 mm), with 96% of cases (23/24) within 10 mm. Evaluation of the model in Cohort 2 found r = 0.81, a median absolute difference of 3.3 mm (interquartile range, 1.1–7.2 mm), and 92% of cases (24/26) within 10 mm. Predictive errors were significantly smaller in both cohorts than in endoscopic findings (Cohort 1, P = 0.004; Cohort 2, P = 0.002). Conclusions: A PET-CT-based approach using the craniocaudal distance from the VCF to the proximal margin could estimate EIL with sufficient accuracy to support surgical decision-making in clinical practice.
Publisher	Springer
Source Title	Esophagus
Date of Issued	2026-01-28
Language	English
Handle URL	https://hdl.handle.net/11094/104236
PISSN	16129059
eISSN	16129067
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1007/s10388-026-01183-6
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Esophagus. 2026
DC.title	Estimation of esophageal involvement length in esophagogastric junction tumors using PET-CT
DC.creator	Nagano, Shinnosuke
	Kurokawa, Yukinori
	Hagi, Takaomi
	Saito, Takuro
	Takahashi, Tsuyoshi
	Nakai, Shigeto
	Momose, Kota
	Yamashita, Kotaro
	Tanaka, Koji
	Makino, Tomoki
	Nakajima, Kiyokazu
	Eguchi, Hidetoshi
	Doki, Yuichiro
DC.publisher	Springer
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2026-01-28
DC.identifier	https://doi.org/10.1007/s10388-026-01183-6
DC.subject	Esophageal involvement length
	Esophagogastric junction tumors
	PET-CT
	Proximal tumor margin
	Vena cava foramen
DC.description	Nagano S., Kurokawa Y., Hagi T., et al. Estimation of esophageal involvement length in esophagogastric junction tumors using PET-CT. Esophagus (2026); https://doi.org/10.1007/s10388-026-01183-6.
DCTERMS.abstract	Background: Esophageal involvement length (EIL) is crucial to determining the surgical strategy for esophagogastric junction (EGJ) tumors. This study developed a positron emission tomography–computed tomography (PET-CT)-based method using anatomical landmarks to estimate EIL and evaluated the clinical utility of the model. Methods: We enrolled 50 patients with EGJ adenocarcinoma who underwent surgical resection. Among patients who underwent upfront surgery (Cohort 1, n = 24), craniocaudal distances were measured from the right and left diaphragms and vena cava foramen (VCF) to the proximal tumor margin on PET-CT images and correlated with histological EIL to establish the best-performing model. Predictive ability was validated in patients who underwent surgery after neoadjuvant chemotherapy (Cohort 2, n = 26). Results: In Cohort 1, among the three anatomical landmarks, VCF most strongly correlated with histological EIL (r = 0.81), providing the following formula: Predicted EIL (mm) = 22 + 0.3 × [Craniocaudal distance from VCF to proximal tumor margin (mm)]. The median absolute difference between the histological and predicted EILs was 4.6 mm (interquartile range, 1.6–6.3 mm), with 96% of cases (23/24) within 10 mm. Evaluation of the model in Cohort 2 found r = 0.81, a median absolute difference of 3.3 mm (interquartile range, 1.1–7.2 mm), and 92% of cases (24/26) within 10 mm. Predictive errors were significantly smaller in both cohorts than in endoscopic findings (Cohort 1, P = 0.004; Cohort 2, P = 0.002). Conclusions: A PET-CT-based approach using the craniocaudal distance from the VCF to the proximal margin could estimate EIL with sufficient accuracy to support surgical decision-making in clinical practice.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	104236
citation_title	Estimation of esophageal involvement length in esophagogastric junction tumors using PET-CT
citation_author	Nagano, Shinnosuke
	Kurokawa, Yukinori
	Hagi, Takaomi
	Saito, Takuro
	Takahashi, Tsuyoshi
	Nakai, Shigeto
	Momose, Kota
	Yamashita, Kotaro
	Tanaka, Koji
	Makino, Tomoki
	Nakajima, Kiyokazu
	Eguchi, Hidetoshi
	Doki, Yuichiro
citation_publisher	Springer
citation_language	English
citation_date	2026-01-28
citation_journal_title	Esophagus
citation_doi	https://doi.org/10.1007/s10388-026-01183-6
citation_public_url	https://hdl.handle.net/11094/104236

Estimation of esophageal involvement length in esophagogastric junction tumors using PET-CT

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