This study evaluated the tumoral texture analysis on baseline and post-treatment CT scans of 31 patients with localized resectable esophageal cancer patients with a median age of 63 and who received neoadjuvant chemotherapy between 2007 and 2010. CT scans were performed before and after the use of chemotherapy and prior to surgery.All patients received platinum and fluorouracil-based chemotherapy followed by surgery. Texture parameters (mean-grey level intensity (MGI), entropy, uniformity, kurtosis, skewness and standard deviation of histogram (SDH)) were derived for four filter values to highlight structures of different spatial width: 1.0 (fine texture), 1.5-2.0 (medium) and 2.5 (coarse). Median follow-up was 21.9 months. Primary tumors became more homogenous following chemotherapy, as entropy decreased and uniformity increased. Smaller change in skewness following chemotherapy was a significant prognostic factor—median overall survival was 36.1 months vs. 11.1 months. Lower baseline entropy and lower post-treatment MGI were also associated with improved survival, although they demonstrated only a trend toward significance.
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