1
|
Kosugi Y, Sasai K, Murakami N, Karino T, Muramoto Y, Kawamoto T, Oshima M, Okonogi N, Takatsu J, Iijima K, Karube S, Isobe A, Hara N, Fujimaki M, Ohba S, Matsumoto F, Murakami K, Shikama N. Efficacy and safety of FDG-PET for determining target volume during intensity-modulated radiotherapy for head and neck cancer involving the oral level. EJNMMI REPORTS 2024; 8:6. [PMID: 38748042 PMCID: PMC10962625 DOI: 10.1186/s41824-024-00197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 02/22/2024] [Indexed: 05/19/2024]
Abstract
PURPOSE To determine the efficacy and safety of target volume determination by 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) for intensity-modulated radiation therapy (IMRT) for locally advanced head and neck squamous cell carcinoma (HNSCC) extending into the oral cavity or oropharynx. METHODS We prospectively treated 10 consecutive consenting patients with HNSCC using IMRT, with target volumes determined by PET-CT. Gross tumor volume (GTV) and clinical target volume (CTV) at the oral level were determined by two radiation oncologists for CT, magnetic resonance imaging (MRI), and PET-CT. Differences in target volume (GTVPET, GTVCT, GTVMRI, CTVPET, CTVCT, and CTVMRI) for each modality and the interobserver variability of the target volume were evaluated using the Dice similarity coefficient and Hausdorff distance. Clinical outcomes, including acute adverse events (AEs) and local control were evaluated. RESULTS The mean GTV was smallest for GTVPET, followed by GTVCT and GTVMRI. There was a significant difference between GTVPET and GTVMRI, but not between the other two groups. The interobserver variability of target volume with PET-CT was significantly less than that with CT or MRI for GTV and tended to be less for CTV, but there was no significant difference in CTV between the modalities. Grade ≤ 3 acute dermatitis, mucositis, and dysphagia occurred in 55%, 88%, and 22% of patients, respectively, but no grade 4 AEs were observed. There was no local recurrence at the oral level after a median follow-up period of 37 months (range, 15-55 months). CONCLUSIONS The results suggest that the target volume determined by PET-CT could safely reduce GTV size and interobserver variability in patients with locally advanced HNSCC extending into the oral cavity or oropharynx undergoing IMRT. Trial registration UMIN, UMIN000033007. Registered 16 jun 2018, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037631.
Collapse
Affiliation(s)
- Yasuo Kosugi
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Keisuke Sasai
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
- Department of Radiation Oncology, Kansai Electric Power Hospital, Osaka, Japan
| | - Naoya Murakami
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Tatsuki Karino
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yoichi Muramoto
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Terufumi Kawamoto
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Masaki Oshima
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Noriyuki Okonogi
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Jun Takatsu
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kotaro Iijima
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shuhei Karube
- Department of Radiology, Juntendo University Hospital, Tokyo, Japan
| | - Akira Isobe
- Department of Radiology, Juntendo University Hospital, Tokyo, Japan
| | - Naoya Hara
- Department of Radiology, Juntendo University Hospital, Tokyo, Japan
| | - Mitsuhisa Fujimaki
- Department of Otorhinolaryngology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Shinichi Ohba
- Department of Otorhinolaryngology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Fumihiko Matsumoto
- Department of Otorhinolaryngology, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Koji Murakami
- Department of Radiology, Juntendo University, Tokyo, Japan
| | - Naoto Shikama
- Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| |
Collapse
|
2
|
Safari M, Fatemi A, Archambault L. MedFusionGAN: multimodal medical image fusion using an unsupervised deep generative adversarial network. BMC Med Imaging 2023; 23:203. [PMID: 38062431 PMCID: PMC10704723 DOI: 10.1186/s12880-023-01160-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
PURPOSE This study proposed an end-to-end unsupervised medical fusion generative adversarial network, MedFusionGAN, to fuse computed tomography (CT) and high-resolution isotropic 3D T1-Gd Magnetic resonance imaging (MRI) image sequences to generate an image with CT bone structure and MRI soft tissue contrast to improve target delineation and to reduce the radiotherapy planning time. METHODS We used a publicly available multicenter medical dataset (GLIS-RT, 230 patients) from the Cancer Imaging Archive. To improve the models generalization, we consider different imaging protocols and patients with various brain tumor types, including metastases. The proposed MedFusionGAN consisted of one generator network and one discriminator network trained in an adversarial scenario. Content, style, and L1 losses were used for training the generator to preserve the texture and structure information of the MRI and CT images. RESULTS The MedFusionGAN successfully generates fused images with MRI soft-tissue and CT bone contrast. The results of the MedFusionGAN were quantitatively and qualitatively compared with seven traditional and eight deep learning (DL) state-of-the-art methods. Qualitatively, our method fused the source images with the highest spatial resolution without adding the image artifacts. We reported nine quantitative metrics to quantify the preservation of structural similarity, contrast, distortion level, and image edges in fused images. Our method outperformed both traditional and DL methods on six out of nine metrics. And it got the second performance rank for three and two quantitative metrics when compared with traditional and DL methods, respectively. To compare soft-tissue contrast, intensity profile along tumor and tumor contours of the fusion methods were evaluated. MedFusionGAN provides a more consistent, better intensity profile, and a better segmentation performance. CONCLUSIONS The proposed end-to-end unsupervised method successfully fused MRI and CT images. The fused image could improve targets and OARs delineation, which is an important aspect of radiotherapy treatment planning.
Collapse
Affiliation(s)
- Mojtaba Safari
- Département de Physique, de génie Physique et d'Optique, et Centre de Recherche sur le Cancer, Université Laval, Québec City, QC, Canada.
- Service de Physique Médicale et Radioprotection, Centre Intégré de Cancérologie, CHU de Québec - Université Laval et Centre de recherche du CHU de Québec, Québec City, QC, Canada.
| | - Ali Fatemi
- Department of Physics, Jackson State University, Jackson, MS, USA
- Department of Radiation Oncology, Gamma Knife Center, Merit Health Central, Jackson, MS, USA
| | - Louis Archambault
- Département de Physique, de génie Physique et d'Optique, et Centre de Recherche sur le Cancer, Université Laval, Québec City, QC, Canada
- Service de Physique Médicale et Radioprotection, Centre Intégré de Cancérologie, CHU de Québec - Université Laval et Centre de recherche du CHU de Québec, Québec City, QC, Canada
| |
Collapse
|
3
|
Decazes P, Hinault P, Veresezan O, Thureau S, Gouel P, Vera P. Trimodality PET/CT/MRI and Radiotherapy: A Mini-Review. Front Oncol 2021; 10:614008. [PMID: 33614497 PMCID: PMC7890017 DOI: 10.3389/fonc.2020.614008] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 12/22/2020] [Indexed: 12/12/2022] Open
Abstract
Computed tomography (CT) has revolutionized external radiotherapy by making it possible to visualize and segment the tumors and the organs at risk in a three-dimensional way. However, if CT is a now a standard, it presents some limitations, notably concerning tumor characterization and delineation. Its association with functional and anatomical images, that are positron emission tomography (PET) and magnetic resonance imaging (MRI), surpasses its limits. This association can be in the form of a trimodality PET/CT/MRI. The objective of this mini-review is to describe the process of performing this PET/CT/MRI trimodality for radiotherapy and its potential clinical applications. Trimodality can be performed in two ways, either a PET/MRI fused to a planning CT (possibly with a pseudo-CT generated from the MRI for the planning), or a PET/CT fused to an MRI and then registered to a planning CT (possibly the CT of PET/CT if calibrated for radiotherapy). These examinations should be performed in the treatment position, and in the second case, a patient transfer system can be used between the PET/CT and MRI to limit movement. If trimodality requires adapted equipment, notably compatible MRI equipment with high-performance dedicated coils, it allows the advantages of the three techniques to be combined with a synergistic effect while limiting their disadvantages when carried out separately. Trimodality is already possible in clinical routine and can have a high clinical impact and good inter-observer agreement, notably for head and neck cancers, brain tumor, prostate cancer, cervical cancer.
Collapse
Affiliation(s)
- Pierre Decazes
- Nuclear Medicine Department, Henri Becquerel Cancer Center, Rouen, France.,QuantIF-LITIS EA4108, University of Rouen, Rouen, France
| | | | - Ovidiu Veresezan
- Radiotherapy Department, Henri Becquerel Cancer Center, Rouen, France
| | - Sébastien Thureau
- Nuclear Medicine Department, Henri Becquerel Cancer Center, Rouen, France.,QuantIF-LITIS EA4108, University of Rouen, Rouen, France.,Radiotherapy Department, Henri Becquerel Cancer Center, Rouen, France
| | - Pierrick Gouel
- Nuclear Medicine Department, Henri Becquerel Cancer Center, Rouen, France.,QuantIF-LITIS EA4108, University of Rouen, Rouen, France
| | - Pierre Vera
- Nuclear Medicine Department, Henri Becquerel Cancer Center, Rouen, France.,QuantIF-LITIS EA4108, University of Rouen, Rouen, France
| |
Collapse
|
4
|
Jensen AD, Langer C. [Late toxicity following primary conservative treatment : Dysphagia and xerostomia]. HNO 2020; 69:263-277. [PMID: 33180145 DOI: 10.1007/s00106-020-00961-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 11/28/2022]
Abstract
Dysphagia and xerostomia are still among the most important acute and late side effects of radiotherapy. Technical developments over the past two decades have led to improved diagnostics and recognition as well as understanding of the causes of these side effects. Based on these findings and advances in both treatment planning and irradiation techniques, the incidence and severity of treatment-associated radiogenic late sequelae could be clearly reduced by the use of intensity-modulated radiotherapy (IMRT), which could contribute to marked long-term improvements in the quality of life in patients with head and neck cancer. Highly conformal techniques, such as proton therapy have the potential to further reduce treatment-associated side effects in head and neck oncology and are currently being prospectively tested within clinical trial protocols at several centers.
Collapse
Affiliation(s)
- A D Jensen
- Klinik für Strahlentherapie, Universitätsklinikum Gießen und Marburg, Klinikstr. 33, 35392, Gießen, Deutschland. .,FB 20 (Medizin), Philipps-Universität Marburg, Marburg, Deutschland.
| | - C Langer
- Klinik für HNO-Heilkunde, Kopf‑/Halschirurgie, Plastische Operationen, Universitätsklinikum Gießen und Marburg, Standort Gießen, Gießen, Deutschland.,Justus-Liebig Universität Gießen, Gießen, Deutschland
| |
Collapse
|
5
|
Practical clinical guidelines for contouring the trigeminal nerve (V) and its branches in head and neck cancers. Radiother Oncol 2018; 131:192-201. [PMID: 30206021 DOI: 10.1016/j.radonc.2018.08.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 01/15/2023]
Abstract
PURPOSE The trigeminal nerve (V) is a major route of tumor spread in several head and neck cancers. However, only limited data are currently available for its precise contouring, although this is absolutely necessary in the era of intensity-modulated radiation therapy (IMRT). The purpose of this article is to present practical clinical guidelines for contouring the trigeminal nerve (V) in head and neck cancers at risk of spread along this nerve. METHOD The main types of head and neck cancers associated with risks of spread along the trigeminal nerve (V) and its branches were comprehensively reviewed based on clinical experience, literature-based patterns of failure, anatomy and radio-anatomy. A consensus for contouring was proposed based on a multidisciplinary approach among head and neck oncology experts including radiation oncologists (JBi, ML, MO, VG and JB), a radiologist (VD) and a surgeon (CS). These practical clinical guidelines have been endorsed by the GORTEC (Head and Neck Radiation Oncology Group). RESULTS We provided contouring and treatment guidelines, supported by detailed figures and tables to help, for the trigeminal nerve and its branches: the ophthalmic nerve (V1), the maxillary nerve (V2) and the manidibular nerve (V3). A CT- and MRI-based atlas was proposed to illustrate the whole trigeminal nerve pathway with its main branches. CONCLUSION Trigeminal nerve (V) invasion is an important component of the natural history of various head and neck cancers. Recognizing the radio-anatomy and potential routes of invasion is essential for optimal contouring, as presented in these guidelines.
Collapse
|
6
|
Perni S, Mohamed ASR, Scott J, Enderling H, Garden AS, Gunn GB, Rosenthal DI, Fuller CD. CT-based volumetric tumor growth velocity: A novel imaging prognostic indicator in oropharyngeal cancer patients receiving radiotherapy. Oral Oncol 2016; 63:16-22. [PMID: 27938995 DOI: 10.1016/j.oraloncology.2016.10.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 10/27/2016] [Accepted: 10/31/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Volumetric tumor growth velocity (TGV) reflects in vitro tumor aggressiveness, but its prognostic value has not been investigated in vivo. We examined the prognostic impact of TGV on oncologic outcomes in patients with oropharyngeal squamous cell cancer (OSCC). MATERIALS AND METHODS 101 OSCC patients with two pretreatment CTs with time gap of 2 or more weeks treated at a single institution between 2004 and 2008 were identified. Primary tumor and nodal targets were segmented in scans. Linear growth rates were calculated. Recursive partitioning analysis (RPA) identified cut point associated with outcomes. RESULTS Median follow-up was 59months (range 7-118). Median primary TGV was 0.65% increase per day (range 0-9.37%). RPA identified TGV cut point associated with local control (LC) of 1% per day. Patients with higher TGV had decreased 5-year LC (73% vs. 98%, p=0.0004), distant control (DC, 62% vs. 91%, p=0.0007), and overall survival (OS, 38% versus 93%, p<0.0001). In multivariate analysis including demographics, tumor stage, subsite, and treatment factors, TGV⩾1% per day independently predicted worsened LC (p = 0.02), DC (p = 0.003), and OS (p < 0.0001). However, this TGV cutoff was not significantly predictive of LC, DC, or OS for a subset of presumed HPV-positive patients. CONCLUSION OSCC TGV⩾1% per day is a substantive negative prognostic indicator for disease control and overall survival, particularly in HPV non-associated tumors. This novel CT-based volumetric assessment of TGV suggests a simple methodology for risk stratification of patients.
Collapse
Affiliation(s)
- Subha Perni
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, USA; Columbia University College of Physicians & Surgeons, 630 West 168th Street, New York, NY, USA.
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, USA; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Chamblion Street, El Azareeta, Alexandria, Egypt.
| | - Jacob Scott
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, USA; Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, USA.
| | - Heiko Enderling
- Department of Integrated Mathematical Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, USA; Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, USA.
| | - Adam S Garden
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, USA
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, USA
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, USA
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, USA.
| |
Collapse
|
7
|
Lapeyre M, Biau J, Racadot S, Moreira J, Berger L, Peiffert D. Radiothérapie des cancers de la cavité buccale. Cancer Radiother 2016; 20 Suppl:S116-25. [DOI: 10.1016/j.canrad.2016.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
8
|
Evaluation of Time-Phase Effect on 18F-FDG PET/CT Delineation Methods for Treatment Planning of Nasopharyngeal Carcinoma. Clin Nucl Med 2016; 41:354-61. [DOI: 10.1097/rlu.0000000000001161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Grégoire V, Langendijk JA, Nuyts S. Advances in Radiotherapy for Head and Neck Cancer. J Clin Oncol 2015; 33:3277-84. [PMID: 26351354 DOI: 10.1200/jco.2015.61.2994] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Over the last few decades, significant improvements have been made in the radiotherapy (RT) treatment of head and neck malignancies. The progressive introduction of intensity-modulated RT and the use of multimodality imaging for target volume and organs at risk delineation, together with the use of altered fractionation regimens and concomitant administration of chemotherapy or targeted agents, have accompanied efficacy improvements in RT. Altogether, such improvements have translated into improvement in locoregional control and overall survival probability, with a decrease in the long-term adverse effects of RT and an improvement in quality of life. Further progress in the treatment of head and neck malignancies may come from a better integration of molecular imaging to identify tumor subvolumes that may require additional radiation doses (ie, dose painting) and from treatment adaptation tracing changes in patient anatomy during treatment. Proton therapy generates even more exquisite dose distribution in some patients, thus potentially further improving patient outcomes. However, the clinical benefit of these approaches, although promising, for patients with head and neck cancer need to be demonstrated in prospective randomized studies. In this context, our article will review some of these advances, with special emphasis on target volume and organ-at-risk delineation, use of molecular imaging for tumor delineation, dose painting for dose escalation, dose adaptation throughout treatment, and potential benefit of proton therapy.
Collapse
Affiliation(s)
- Vincent Grégoire
- Vincent Grégoire, Institut de Recherche Clinique, Université Catholique de Louvain, St-Luc University Hospital, Brussels; Sandra Nuyts, Katholieke Universiteit Leuven-University of Leuven, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; and Johannes A. Langendijk, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Johannes A Langendijk
- Vincent Grégoire, Institut de Recherche Clinique, Université Catholique de Louvain, St-Luc University Hospital, Brussels; Sandra Nuyts, Katholieke Universiteit Leuven-University of Leuven, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; and Johannes A. Langendijk, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Sandra Nuyts
- Vincent Grégoire, Institut de Recherche Clinique, Université Catholique de Louvain, St-Luc University Hospital, Brussels; Sandra Nuyts, Katholieke Universiteit Leuven-University of Leuven, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium; and Johannes A. Langendijk, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
10
|
Davis CA, Thomas C, Abdolell M, Day A, Hollenhorst H, Rajaraman M, Mulroy L, Bowes D, Cwajna S, Rheaume D, Patil N, Burrell S, Wilke D. Investigating the Impact of Positron Emission Tomography–Computed Tomography Versus Computed Tomography Alone for High-risk Volume Selection in Head and Neck and Lung Patients Undergoing Radiotherapy: Interim Findings. J Med Imaging Radiat Sci 2015; 46:148-155. [DOI: 10.1016/j.jmir.2015.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 02/13/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
|
11
|
Özel HE. Use of PET in Head and Neck Cancers. Turk Arch Otorhinolaryngol 2015; 53:73-76. [PMID: 29391984 PMCID: PMC5783004 DOI: 10.5152/tao.2015.863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 05/04/2015] [Indexed: 11/22/2022] Open
Abstract
Head and neck cancer imaging is especially necessary for staging. Computed tomography and magnetic resonance imaging are the techniques frequently used for this purpose. These methods are valuable for displaying detailed anatomical structures; however, they may be inadequate for making the distinction between recurrence, residual tumor, fibrosis, and normal tissues with an altered anatomy after treatments such as surgery, radiotherapy, and chemotherapy and for the detection of metastases. From this point, positron emission tomography may be a promising imaging method. Scanning the entire body with a single method is an important advantage of positron emission tomography. It may be useful in the detection of synchronous tumors, which are a serious problem in head and neck cancers. Positron emission tomography may provide additional contribution for neck metastases, where the primary site is unknown and is undetectable by other imaging techniques.
Collapse
Affiliation(s)
- Halil Erdem Özel
- Department of Otorhinolaryngology, Derince Training and Research Hospital, Kocaeli, Turkey
| |
Collapse
|
12
|
Suarez-Gironzini V, Khoo V. Imaging Advances for Target Volume Definition in Radiotherapy. CURRENT RADIOLOGY REPORTS 2015. [DOI: 10.1007/s40134-015-0092-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
13
|
Lauridsen JK, Rohde M, Thomassen A. 18F-Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography in Malignancies of the Thyroid and in Head and Neck Squamous Cell Carcinoma. PET Clin 2015; 10:75-88. [DOI: 10.1016/j.cpet.2014.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
14
|
Braccini AL, Haberer-Guillerm S, Azria D, Garrel R, Pierre G, Auge Y, Boisselier P. [Radioanatomy of rhinopharyngeal carcinoma]. Cancer Radiother 2014; 17:715-23. [PMID: 24709383 DOI: 10.1016/j.canrad.2013.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/01/2013] [Accepted: 04/11/2013] [Indexed: 11/30/2022]
Abstract
Rhinopharyngeal cancer is one of the best indications for conformal radiotherapy with modulated intensity. Due to the high dose gradient, accurate delineation of target volumes and organs at risk is a critical success factor with this technology. This requires a good knowledge of rhinopharyngeal radioanatomy and optimal imaging techniques.
Collapse
Affiliation(s)
- A L Braccini
- Département de radiothérapie, CRLC Val d'Aurelle-Paul-Lamarque, 208, rue des Apothicaires, 34090 Montpellier, France.
| | - S Haberer-Guillerm
- Département d'oncologie radiothérapie, hôpital Tenon, groupe hospitalier des hôpitaux universitaires de l'Est parisien (HUEP), AP-HP, 4, rue de la Chine, 75020 Paris, France; Faculté de médecine, université Paris-6 Pierre-et-Marie-Curie, 75020 Paris, France
| | - D Azria
- Département de radiothérapie, CRLC Val d'Aurelle-Paul-Lamarque, 208, rue des Apothicaires, 34090 Montpellier, France
| | - R Garrel
- Département de chirurgie ORL, CHU Guy-de-Chauliac, 34295 Montpellier, France
| | - G Pierre
- Département de chirurgie ORL, CHU Guy-de-Chauliac, 34295 Montpellier, France
| | - Y Auge
- Département de radiologie, clinique du Parc, 50, rue Émile-Combes, 34170 Castelnau-le-Lez, France
| | - P Boisselier
- Département de radiothérapie, CRLC Val d'Aurelle-Paul-Lamarque, 208, rue des Apothicaires, 34090 Montpellier, France
| |
Collapse
|
15
|
Liu C, Kong X, Gong G, Liu T, Li B, Yin Y. Error in the parotid contour delineated using computed tomography images rather than magnetic resonance images during radiotherapy planning for nasopharyngeal carcinoma. Jpn J Radiol 2014; 32:211-6. [DOI: 10.1007/s11604-014-0286-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
|
16
|
Délinéation des cancers de la cavité buccale et de l’oropharynx. Cancer Radiother 2013; 17:493-7. [DOI: 10.1016/j.canrad.2013.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 05/25/2013] [Indexed: 12/25/2022]
|
17
|
Medical Imaging of Nasopharyngeal Carcinomas: Current Tools and Applications. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013. [DOI: 10.1007/978-1-4614-5947-7_8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
18
|
Loo SW, Martin WMC, Smith P, Cherian S, Roques TW. Interobserver variation in parotid gland delineation: a study of its impact on intensity-modulated radiotherapy solutions with a systematic review of the literature. Br J Radiol 2012; 85:1070-7. [PMID: 22815411 DOI: 10.1259/bjr/32038456] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study evaluates the interobserver variation in parotid gland delineation and its impact on intensity-modulated radiotherapy (IMRT) solutions. METHODS The CT volumetric data sets of 10 patients with oropharyngeal squamous cell carcinoma who had been treated with parotid-sparing IMRT were used. Four radiation oncologists and three radiologists delineated the parotid gland that had been spared using IMRT. The dose-volume histogram (DVH) for each study contour was calculated using the IMRT plan actually delivered for that patient. This was compared with the original DVH obtained when the plan was used clinically. RESULTS 70 study contours were analysed. The mean parotid dose achieved during the actual treatment was within 10% of 24 Gy for all cases. Using the study contours, the mean parotid dose obtained was within 10% of 24 Gy for only 53% of volumes by radiation oncologists and 55% of volumes by radiologists. The parotid DVHs of 46% of the study contours were sufficiently different from those used clinically, such that a different IMRT plan would have been produced. CONCLUSION Interobserver variation in parotid gland delineation is significant. Further studies are required to determine ways of improving the interobserver consistency in parotid gland definition.
Collapse
Affiliation(s)
- S W Loo
- Department of Clinical Oncology, Norfolk and Norwich University Hospital, Norwich, UK.
| | | | | | | | | |
Collapse
|
19
|
Yoo J, Henderson S, Walker-Dilks C. Evidence-based guideline recommendations on the use of positron emission tomography imaging in head and neck cancer. Clin Oncol (R Coll Radiol) 2012; 25:e33-66. [PMID: 23021712 DOI: 10.1016/j.clon.2012.08.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 07/26/2012] [Indexed: 02/07/2023]
Abstract
AIMS To provide evidence-based practice guideline recommendations on the use of fluoro-2-deoxy-D-glucose positron emission tomography (PET) for diagnosis, staging and assessing treatment response, restaging or recurrence of head and neck cancer. MATERIALS AND METHODS A systematic review by Facey et al. (Health Technology Assessment 2007;11(44):iii-iv, xi-267) was used as the evidence base for recommendation development. As the review was limited to August 2005, the evidence base was updated to July 2011 using the same search strategies for MEDLINE and EMBASE used in the original review. The authors of the current systematic review drafted recommendations, which were reviewed, adapted and accepted by consensus by the Ontario provincial Head and Neck Disease Site Group and a special meeting of clinical experts. RESULTS The results of the Facey et al. review for head and neck cancer included five other systematic reviews and 31 primary studies. The 2005 to 2011 update search included four additional systematic reviews and 53 primary studies. Recommendations were developed based on this evidence and accepted by consensus. CONCLUSIONS PET is recommended in the M and bilateral nodal staging of all patients with head and neck squamous cell carcinoma where conventional imaging is equivocal, or where treatment may be significantly modified. PET is recommended in all patients after conventional imaging and in addition to, or prior to, diagnostic panendoscopy where the primary site is unknown. PET is recommended for the staging and assessment of recurrence of patients with nasopharyngeal carcinoma if conventional imaging is equivocal. PET is recommended for restaging patients who are being considered for major salvage treatment, including neck dissection.
Collapse
Affiliation(s)
- J Yoo
- Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine & Dentistry, Western University, Victoria Hospital, London Health Sciences Centre, Ontario, Canada
| | | | | |
Collapse
|
20
|
A prospective study on volumetric and dosimetric changes during intensity-modulated radiotherapy for nasopharyngeal carcinoma patients. Radiother Oncol 2012; 104:317-23. [DOI: 10.1016/j.radonc.2012.03.013] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 03/20/2012] [Accepted: 03/26/2012] [Indexed: 11/21/2022]
|
21
|
Variations in the Contouring of Organs at Risk: Test Case From a Patient With Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2012; 82:368-78. [DOI: 10.1016/j.ijrobp.2010.10.019] [Citation(s) in RCA: 149] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2010] [Revised: 10/13/2010] [Accepted: 10/19/2010] [Indexed: 12/25/2022]
|
22
|
Fried D, Khandani A, Shores C, Weissler M, Hayes N, Hackman T, Rosenman J, Chera BS. Matched cohort analysis of the effect of pretreatment positron emission tomography on clinical outcomes of patients with head and neck cancer treated with definitive chemoradiotherapy. Head Neck 2011; 34:412-7. [PMID: 21853498 DOI: 10.1002/hed.21745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 01/04/2011] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Pretreatment positron emission tomography (PET) has been shown to be useful for patients with head and neck squamous cell carcinoma (HNSCC) after definitive chemoradiotherapy (CRT). METHODS We conducted a retrospective analysis of a matched cohort of 116 patients with HNSCC that underwent CRT treatment at our institution. Pretreatment PET was performed in 58 patients and omitted in the other 58 patients. The 2 cohorts were matched for T classification, N classification, primary site, and smoking history. Kaplan-Meier 2-year estimates of local control (LC), regional control (RC), freedom from distant metastasis (FFDM), cause-specific survival (CSS), and overall survival (OS) were compared with log-rank tests. RESULTS There were no differences between the 2 cohorts for 2-year endpoints of LC, RC, FFDM, CSS, and OS. On multivariate analysis pretreatment PET imaging did not influence any endpoint. CONCLUSIONS PET imaging before definitive CRT may not significantly improve outcomes in patients with HNSCC.
Collapse
Affiliation(s)
- David Fried
- Department of Radiation Oncology, UNC Hospitals, NC Clinical Cancer Center, Chapel Hill, North Carolina, USA
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Wu HB, Wang QS, Wang MF, Zhen X, Zhou WL, Li HS. Preliminary study of 11C-choline PET/CT for T staging of locally advanced nasopharyngeal carcinoma: comparison with 18F-FDG PET/CT. J Nucl Med 2011; 52:341-6. [PMID: 21321282 DOI: 10.2967/jnumed.110.081190] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Evaluation of nasopharyngeal carcinoma (NPC) using (18)F-FDG PET/CT is limited by the intense physiologic uptake of (18)F-FDG in the brain. We attempted to improve detection of intracranial tumor invasion (including better delineation of invasion near the skull base) in locally advanced NPC using(11)C-choline PET/CT. METHODS Fifteen patients with newly diagnosed or recurrent locally advanced NPC were enrolled in the study. (18)F-FDG and (11)C-choline PET/CT was performed on all patients. PET/CT images obtained using the 2 tracers were compared using both maximum standardized uptake value (SUVmax) and tumor-to-brain (T/B) ratios. All patients were followed up for more than 1 y. RESULTS The sensitivity of (18)F-FDG PET/CT in detecting locally advanced NPC was 86.6%, compared with a 100% sensitivity for (11)C-choline PET/CT (t = 2.143, P = 0.483). The SUVmax of lesions detected was higher using (18)F-FDG than using (11)C-choline (12.81 ± 5.00 vs. 6.84 ± 2.76, t = 6.416, P < 0.001), but the T/B ratio was much higher for (11)C-choline than for (18)F-FDG (18.62 ± 7.95 vs. 1.38 ± 0.59, t = 8.801, P < 0.001). Compared with (18)F-FDG PET/CT, (11)C-choline PET/CT improved the delineation of intracranial invasion in 6 of 12 patients (χ(2) = 8.00, P = 0.014), skull base invasion in 4 of 14 patients, and orbital invasion in 3 of 3 patients. CONCLUSION (11)C-choline can improve the quality of PET/CT in the T staging of NPC.
Collapse
Affiliation(s)
- Hu-bing Wu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | | | | | | | | | | |
Collapse
|
24
|
Boss A, Stegger L, Bisdas S, Kolb A, Schwenzer N, Pfister M, Claussen CD, Pichler BJ, Pfannenberg C. Feasibility of simultaneous PET/MR imaging in the head and upper neck area. Eur Radiol 2011; 21:1439-46. [PMID: 21308378 DOI: 10.1007/s00330-011-2072-z] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 12/14/2010] [Accepted: 01/20/2011] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this pilot study was to test and demonstrate the feasibility of simultaneous positron emission tomography (PET) and magnetic resonance imaging (MRI) of the head and upper neck area using a new hybrid PET/MRI system. METHODS Eight patients with malignant head and neck tumours were included in the pilot study. Directly after routine PET/CT imaging with a whole-body system using the glucose derivative 2-[¹⁸F]fluoro-2deoxy-D-glucose (FDG) as a radiotracer additional measurements were performed with a prototype PET/MRI system for simultaneous PET and MR imaging. Physiological radiotracer uptake within regular anatomical structures as well as tumour uptake were evaluated visually and semiquantitatively (metabolic ratios) in relation to cerebellar uptake on the PET/MRI and PET/CT systems. RESULTS The MR datasets showed excellent image quality without any recognisable artefacts caused by the inserted PET system. PET images obtained with the PET/MRI system exhibited better detailed resolution and greater image contrast in comparison to those from the PET/CT system. An excellent agreement between metabolic ratios obtained with both PET systems was found: R = 0.99 for structures with physiological tracer uptake, R = 0.96 for tumours. CONCLUSION Simultaneous PET/MRI of the head and upper neck area is feasible with the new hybrid PET/MRI prototype.
Collapse
Affiliation(s)
- Andreas Boss
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Conservation of salivary function and new external head and neck radiation techniques. Eur Ann Otorhinolaryngol Head Neck Dis 2010; 127:197-203. [PMID: 21123132 DOI: 10.1016/j.anorl.2010.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 09/10/2010] [Accepted: 09/10/2010] [Indexed: 12/17/2022]
Abstract
INTRODUCTION New radiation therapy techniques seek to adapt dose distribution to three-dimensional tumor geometry, so as to deliver the lowest possible dose to normal tissue and at-risk organs. This is expected to enhance locoregional control and survival and to reduce complications and thereby improve quality of life. Post-radiation xerostomia significantly deteriorates quality of life. MATERIAL AND METHODS New external radiation techniques (such as intensity-modulated conformal radiation therapy, RapidArc VMAT arc therapy, tomotherapy, CyberKnife(®), protontherapy, use of carbon ions) applicable in ENT are reviewed. RESULTS Preliminary data show interesting results in terms of salivary function with highly conformal techniques. CONCLUSION In France, assessment is ongoing, financed under the Health Ministry's "Support for Expensive Innovatory Techniques" scheme (STIC [Soutien aux techniques innovantes coûteuses]), as routine use is growing rapidly.
Collapse
|
26
|
Current world literature. Curr Opin Otolaryngol Head Neck Surg 2010; 18:134-45. [PMID: 20234215 DOI: 10.1097/moo.0b013e3283383ef9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
27
|
Truong MT, Grillone G, Tschoe C, Chin L, Kachnic LA, Jalisi S. Emerging applications of stereotactic radiotherapy in head and neck cancer. Neurosurg Focus 2009; 27:E11. [DOI: 10.3171/2009.9.focus09199] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Advances in the management of locally advanced head and neck cancer (HNC) have been focused on treatment intensification, including concomitant chemoradiotherapy, biological agents, and combining surgery with chemoradiotherapy. Despite these improvements, locoregional recurrence still constitutes the main pattern of treatment failure. As improvements in radiotherapy delivery and image-guided therapy have come to fruition, the principles of stereotactic radiosurgery are now being applied to extracranial sites, leading to stereotactic body radiotherapy. This article focuses on the emerging evidence for the use of stereotactic body radiotherapy for treatment of HNC as a boost after conventional external-beam radiotherapy, and also as reirradiation in recurrent or second primary HNC.
Collapse
Affiliation(s)
| | | | - Christine Tschoe
- 3Neurosurgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Lawrence Chin
- 3Neurosurgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | | | - Scharukh Jalisi
- 2Otolaryngology, and
- 3Neurosurgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| |
Collapse
|
28
|
Recent advances in image-guided radiotherapy for head and neck carcinoma. JOURNAL OF ONCOLOGY 2009; 2009:752135. [PMID: 19644564 PMCID: PMC2717698 DOI: 10.1155/2009/752135] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 05/29/2009] [Accepted: 06/03/2009] [Indexed: 11/17/2022]
Abstract
Radiotherapy has a well-established role in the management of head and neck cancers. Over the past decade, a variety of new imaging modalities have been incorporated into the radiotherapy planning and delivery process. These technologies are collectively referred to as image-guided radiotherapy and may lead to significant gains in tumor control and radiation side effect profiles. In the following review, these techniques as they are applied to head and neck cancer patients are described, and clinical studies analyzing their use in target delineation, patient positioning, and adaptive radiotherapy are highlighted. Finally, we conclude with a brief discussion of potential areas of further radiotherapy advancement.
Collapse
|