1 3 Radiol med DOI 10.1007/s11547-014-0466-0 COMPUTED TOMOGRAPHY Oesophageal cancer: assessment of tumour response to chemoradiotherapy with tridimensional CT Rita Alfieri · Giovanna Pintacuda · Matteo Cagol · Tommaso Occhipinti · Ivan Capraro · Marco Scarpa · Gianpietro Zanchettin · Francesco Cavallin · Mauro Michelotto · Luciano Giacomelli · Ermanno Ancona · Carlo Castoro Received: 29 January 2014 / Accepted: 30 May 2014 © Italian Society of Medical Radiology 2014 1.79–21.0) and 33.80 cm 3 (range 3.36–101.6), respectively. Differences in TV between the pre- and post-treatment val- ues were significantly correlated with the pathological stage (τ = 0.357, p = 0.004) and the tumour regression grade index (τ = 0.368, p = 0.005). According to the receiver operating characteristic analysis, TV measurements fol- lowing treatment had moderate predictive values for the pathological T stage (area under the curve, AUC = 0.742, sensitivity = 55.56 %, specificity = 92.86 %, p = 0.005). Comparison of pathological and radiological volume showed a good precision (Pearson rho 0.77). Conclusions Changes in TV calculated on CT scans have a limited role in predicting pathological response to neoad- juvant treatment in oesophageal cancer patients. New imag- ing techniques based on metabolic imaging may provide better results. Keywords Esophageal cancer · Tumour volume · Clinical response · Neoadjuvant treatment Introduction The World Health Organization divided tumour response to chemotherapy and/or radiotherapy into four categories: complete response (CR) indicating no evidence of disease; partial response (PR) indicating a 50 % reduction in tumour area; progressive disease (PD) indicating a 25 % increase in tumour area or a visible new lesion; and stable disease (SD) when neither PR nor PD is detected [1]. In 2000, the response evaluation criteria in solid tumors (RECIST) clas- sification were proposed as the new guidelines to evaluate tumour response using unidimensional measurements and were subsequently revised in 2009 [2, 3]. The percentage changes in total tumour burden that define the categories of Abstract Purpose To investigate whether changes in tumour vol- ume were predictive of histopathological response to neo- adjuvant therapy for oesophageal cancer. Materials and methods Thirty-five consecutive patients with locally advanced oesophageal cancer were treated with chemoradiotherapy and surgery in responders from July 2007 to July 2009. Tumour volume (TV) was calcu- lated using innovative tumour volume estimation software which analysed computed tomography (CT) data. Tumour diameter and area were also evaluated. Variations in tumour measurements following neoadjuvant treatment were com- pared with the histopathological data. Results Median baseline tumour diameter, area and vol- ume were 3.51 cm (range 1.67–6.61), 7.51 cm 2 (range R. Alfieri (*) · M. Cagol · M. Scarpa · F. Cavallin · E. Ancona · C. Castoro Department of Surgical Oncology, Veneto Institute of Oncology-IRCCS, Padova, Italy e-mail: rita.alfieri@ioveneto.it G. Pintacuda Oncological Radiology, Veneto Institute of Oncology-IRCCS, Padova, Italy T. Occhipinti Veneto Institute of Oncology-IRCCS, Padova, Italy I. Capraro Department of Engineering, University of Padova, Padova, Italy G. Zanchettin Department of Surgical and Gastroenterological Sciences, Clinica Chirurgica 1 University of Padova, Padova, Italy M. Michelotto · L. Giacomelli Department of Medicine, Surgical Pathology, University of Padova, Padova, Italy