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Yui M, Matsuno Y, Furukawa T, Teshima M, Shinomiya H, Kiyota N, Nomura T, Miyawaki D, Sasaki R, Nibu KI. Oncological Outcomes of Concurrent Chemoradiotherapy and Surgical Treatment for Patients With T3 Hypopharyngeal Cancer: A Single-Center Retrospective Analysis. Cureus 2024; 16:e62553. [PMID: 38894937 PMCID: PMC11182762 DOI: 10.7759/cureus.62553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2024] [Indexed: 06/21/2024] Open
Abstract
Background Since the larynx and pharynx are vital for respiration, swallowing, and speech, chemoradiotherapy (CRT) has been widely applied for T3 hypopharyngeal cancer (HPC) as an organ-preserving treatment. However, CRT can lead to severe late adverse events such as dysphagia and aspiration pneumonia, especially in patients who have difficulty swallowing and/or aspiration at the time of initial diagnosis. Patients and methods Between 2012 and 2020, 86 patients with T3 HPC treated with curative intent at Kobe University Hospital were included in this study. The average age was 69 years old, ranging from 43 to 89. Diseases were classified as Stage III in 29 patients, Stage IVA in 52 patients, and Stage IVB in five patients. Thirty-five (41%) patients were treated by CRT, and 51 (59%) patients were treated by surgery. Patients were followed up for at least two years, and the follow-up period ranged from four to 128 months (median: 45 months). Results Three-year progression-free survival (PFS) rates of patients treated by CRT and patients treated by surgery were 56.2% and 60.3%, respectively. Three-year disease-specific survival (DSS) rates of patients treated by CRT and surgically treated patients were 79.0% vs. 70.8%, respectively. Three-year overall survival (OS) rates of patients treated by CRT and surgically treated patients were 64.5% and 69.0%, respectively. Of note, a significant difference was observed between three-year DSS and three-year PFS (79.0% vs. 56.2%, p = 0.0014) in the patients treated by CRT but not in the patients treated by surgery. Conclusions No significant differences were observed between the PFS, DSS, and OS rates of patients treated by CRT and those of surgically treated patients. Locoregional recurrences after CRT were significantly successfully salvaged by surgical intervention. These results suggest that CRT can be applied as an alternative to surgery without reducing survival, especially for patients without severe clinical symptoms. Meticulous follow-up is mandatory for early detection of recurrence to salvage by surgery and for the management of late adverse events.
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Affiliation(s)
- Mitsuko Yui
- Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Yoshihisa Matsuno
- Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Tatsuya Furukawa
- Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Masanori Teshima
- Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Hirotaka Shinomiya
- Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Naomi Kiyota
- Medical Oncology and Hematology, Cancer Center, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Tadashi Nomura
- Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Daisuke Miyawaki
- Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Ryohei Sasaki
- Radiation Oncology, Kobe University Hospital, Hyogo, JPN
| | - Ken-Ichi Nibu
- Otolaryngology - Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, JPN
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Zhou Z, Tang J, Lu Y, Jia J, Luo T, Su K, Dai X, Zhang H, Liu O. Prognosis-related molecular subtyping in head and neck squamous cell carcinoma patients based on glycolytic/cholesterogenic gene data. Cancer Cell Int 2023; 23:37. [PMID: 36841765 PMCID: PMC9960414 DOI: 10.1186/s12935-023-02880-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/19/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) remains an unmet medical challenge. Metabolic reprogramming is a hallmark of diverse cancers, including HNSCC. METHODS We investigated the metabolic profile in HNSCC by using The Cancer Genome Atlas (TCGA) (n = 481) and Gene Expression Omnibus (GEO) (n = 97) databases. The metabolic stratification of HNSCC samples was identified by using unsupervised k-means clustering. We analyzed the correlations of the metabolic subtypes in HNSCC with featured genomic alterations and known HNSCC subtypes. We further validated the metabolism-related subtypes based on features of ENO1, PFKFB3, NSDHL and SQLE expression in HNSCC by Immunohistochemistry. In addition, genomic characteristics of tumor metabolism that varied among different cancer types were confirmed. RESULTS Based on the median expression of coexpressed cholesterogenic and glycolytic genes, HNSCC subtypes were identified, including glycolytic, cholesterogenic, quiescent and mixed subtypes. The quiescent subtype was associated with the longest survival and was distributed in stage I and G1 HNSCC. Mutation analysis of HNSCC genes indicated that TP53 has the highest mutation frequency. The CDKN2A mutation frequency has the most significant differences amongst these four subtypes. There is good overlap between our metabolic subtypes and the HNSCC subtype. CONCLUSION The four metabolic subtypes were successfully determined in HNSCC. Compared to the quiescent subtype, glycolytic, cholesterogenic and mixed subtypes had significantly worse outcome, which might offer guidelines for developing a novel treatment strategy for HNSCC.
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Affiliation(s)
- Zekun Zhou
- grid.216417.70000 0001 0379 7164Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008 Hunan China
| | - Jianfei Tang
- grid.216417.70000 0001 0379 7164Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008 Hunan China
| | - Yixuan Lu
- grid.216417.70000 0001 0379 7164Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008 Hunan China
| | - Jia Jia
- grid.216417.70000 0001 0379 7164Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008 Hunan China
| | - Tiao Luo
- grid.216417.70000 0001 0379 7164Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008 Hunan China
| | - Kaixin Su
- grid.216417.70000 0001 0379 7164Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008 Hunan China
| | - Xiaohan Dai
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China.
| | - Haixia Zhang
- The Oncology Department of Xiangya Second Hospital, Central South University, Changsha, 410011, Hunan, China.
| | - Ousheng Liu
- Hunan Key Laboratory of Oral Health Research & Hunan 3D Printing Engineering Research Center of Oral Care & Hunan Clinical Research Center of Oral Major Diseases and Oral Health & Academician Workstation for Oral-maxilofacial and Regenerative Medicine & Xiangya Stomatological Hospital & Xiangya School of Stomatology, Central South University, Changsha, 410008, Hunan, China.
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Prognostic Value of 18F-Fluorodeoxyglucose–Positron Emission Tomography/Magnetic Resonance Imaging in Patients With Hypopharyngeal Squamous Cell Carcinoma. J Comput Assist Tomogr 2022; 46:968-977. [DOI: 10.1097/rct.0000000000001365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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4
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Morand GB. [Metabolic Tumor Imaging in Head and Neck Oncology]. PRAXIS 2022; 111:878-883. [PMID: 36415988 DOI: 10.1024/1661-8157/a003926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Metabolic Tumor Imaging in Head and Neck Oncology Abstract. Fluorodeoxyglucose with position emission tomography combined with CT or MRI (FDG-PET) has become an important diagnostic and staging method in head and neck squamous cell carcinoma. Some regard FDG-PET merely as a tool able of displaying cancer cells as bright spots on imaging. However, quantification of FDG uptake can be used as a surrogate marker for tumor aggressiveness and predict tumor response before (chemo)-radiation. The FDG uptake of the primary tumor can also predict surgical outcome measures such as depth of invasion, occult nodal metastasis, or bone invasion for oral cancer and/or organ preservation in hypopharyngeal cancer.
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Jin A, Lin X, Yin X, Cui Y, Ma L. Prognostic value of MTV and TLG of 18 F-FDG PET in patients with head and neck squamous cell carcinoma: A meta-analysis. Medicine (Baltimore) 2022; 101:e30798. [PMID: 36181127 PMCID: PMC9524907 DOI: 10.1097/md.0000000000030798] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The current systematic review and meta-analysis explored the value of metabolic tumor volume (MTV) as well as total lesion glycolysis (TLG) in predicting the prognosis of head and neck squamous cell carcinoma (HNSCC) using 18 F-FDG PET parameters. METHODS This work identified relevant studies in the English language by searching several electronic databases, like Cochrane Library, EMBASE, and PubMed. In addition, pooled hazard ratios (HRs) were also calculated to analyze whether MTV and TLG were significant in predicting prognosis. RESULTS The present study included 15 primary studies involving HNSCC cases. As for the elevated TLG, it attained the pooled HR of 1.85 (95% confidence interval [CI], 1.16-2.94; P = .000; I2 = 78.3%) in predicting overall survival (OS), whereas that for elevated MTV was1.22 (95%CI, 1.09-1.36; P = .000; I2 = 82.4%). Besides, for elevated MTV, it attained the pooled HR of 1.34 (95%CI, 1.15-1.56, P = .000; I2 = 86.0%) in predicting disease-free survival (DFS); while the elevated TLG was related to DFS. Sensitivity analysis confirmed that our results are reliable. As for MTV, the ROC-stratified subgroups for DFS and multivariate analyses-stratified subgroups for OS showed statistically significant differences, with no obvious heterogeneities across different studies. For TLG, other methods-stratified subgroups for OS showed statistically significant differences, with no obvious heterogeneity across different studies. CONCLUSION This work indicated that PET/CT is of predictive significance across HNSCC cases. Although the included articles used different methods and recruited HNSCC cases with high clinical heterogeneity; however, our findings confirmed that an elevated MTV can predict the increased risk of side reactions or even death among HNSCC cases and that an elevated TLG can predict a higher death risk.
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Affiliation(s)
- Aihua Jin
- Department of Clinical Laboratory, Yanbian University Hospital, Yanji, Jilin Province, China
| | - Xing Lin
- Department of Thoracic Surgery, Yanbian University Hospital, Yanji, Jilin Province, China
| | - Xuezhe Yin
- Department of Respiration Medicine, Yanbian University Hospital, Yanji, Jilin Province, China
| | - Yinfeng Cui
- Department of Stomatology, Medical College of Yanbian University, Jilin Province, China
- *Correspondence: Liguang Ma and Yinfeng Cui, Department of College of Yanbian University, Jilin Province 133000, China (e-mail: and )
| | - Liguang Ma
- Department of Stomatology, Medical College of Yanbian University, Jilin Province, China
- *Correspondence: Liguang Ma and Yinfeng Cui, Department of College of Yanbian University, Jilin Province 133000, China (e-mail: and )
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Suzuki S, Toyoma S, Abe T, Endo T, Kouga T, Kaswasaki Y, Yamada T. 18F-FDG-PET/CT can be used to predict distant metastasis in hypopharyngeal squamous cell carcinoma. J Otolaryngol Head Neck Surg 2022; 51:13. [PMID: 35365214 PMCID: PMC8973647 DOI: 10.1186/s40463-022-00568-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/26/2022] [Indexed: 11/29/2022] Open
Abstract
Background Hypopharyngeal squamous cell carcinoma (HPSCC) has a high rate of distant metastasis, resulting in poor prognosis. The role of the maximum standardized uptake value (SUVmax), which was assessed via pretreatment 18-fluorodeoxyglucose positron emission tomography (FDG-PET), and computed tomography (CT) was examined, for predicting distant metastasis and survival. Methods This study included 121 patients who underwent pretreatment FDG-PET/CT scanning and subsequent treatment for HPSCC. The SUVmax was measured via FDG-PET/CT. A receiver operating characteristic (ROC) curve analysis was used to determine whether the SUVmax was a predictor of distant metastasis and to select the best cutoff value. Univariate and multivariate Cox hazard regression analyses were used in identifying associations between the SUVmax and other clinicopathological factors with distant metastasis-free survival. Results Distant metastases were identified in 33 patients during the median follow-up of 24 months after treatment. The ROC curve analysis determined that SUVmax was predictive of distant metastasis and identified a SUVmax of 13.9 as the best potential cutoff value. The univariate analysis showed that T and N classification, clinical stage, and SUVmax were significantly related to distant metastasis. However, in multivariate analysis, an SUVmax ≥ 13.9 was the only independent predictor of distant metastasis. Patients with high SUVmax values displayed significantly shorter distant metastasis-free survival and overall survival. Conclusions SUVmax determined via pretreatment FDG-PET/CT is useful for predicting distant metastasis, distant metastasis-free survival, and overall survival in patients with HPSCC. Graphical Abstract ![]()
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Affiliation(s)
- Shinsuke Suzuki
- Department of Otorhinolaryngology and Head and Neck Surgery, Akita University Graduate School of Medicine, Akita, 010-8543, Japan.
| | - Satoshi Toyoma
- Department of Otorhinolaryngology and Head and Neck Surgery, Akita University Graduate School of Medicine, Akita, 010-8543, Japan
| | - Tomoe Abe
- Department of Otorhinolaryngology and Head and Neck Surgery, Akita University Graduate School of Medicine, Akita, 010-8543, Japan
| | - Tentaro Endo
- Department of Otorhinolaryngology and Head and Neck Surgery, Akita University Graduate School of Medicine, Akita, 010-8543, Japan
| | - Teppei Kouga
- Department of Otorhinolaryngology and Head and Neck Surgery, Akita University Graduate School of Medicine, Akita, 010-8543, Japan
| | - Yohei Kaswasaki
- Department of Otorhinolaryngology and Head and Neck Surgery, Akita University Graduate School of Medicine, Akita, 010-8543, Japan
| | - Takechiyo Yamada
- Department of Otorhinolaryngology and Head and Neck Surgery, Akita University Graduate School of Medicine, Akita, 010-8543, Japan
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Nikkuni Y, Nishiyama H, Hyayashi T. Histogram analysis of 18F-FDG PET imaging SUVs may predict the histologic grade of oral squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:254-261. [PMID: 35599213 DOI: 10.1016/j.oooo.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 02/27/2022] [Accepted: 03/05/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We tested the hypothesis that histogram analysis parameters of standardized uptake values (SUVs) obtained preoperatively using 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) are significantly influenced by differences in metabolic capacity due to the histologic grade of oral squamous cell carcinoma (OSCC). STUDY DESIGN The study included 62 patients who were clinically diagnosed with OSCC and received surgical treatment after an 18F-FDG PET examination. Histogram analysis was performed using all voxels contained in the tumor area of each patient with an SUV ≥2.5. The histogram parameters calculated were the mean and standard deviation of SUVs, maximum SUV, metabolic tumor volume, skewness, and kurtosis. Statistical analyses were performed using a Mann-Whitney U test to calculate the significance of differences in these parameters between groups with well- and moderately- or poorly-differentiated tumors. Statistical significance was assumed at P < .05. RESULTS Only a comparison of kurtosis in the histogram showed a significant difference between the well- and moderately/poorly-differentiated tumors (P = .0294). CONCLUSIONS The distribution of metabolic capacity in oral squamous cell carcinoma tissues revealed on an 18F-FDG PET examination may help identify the histologic grade. This finding may provide valuable information for determining the subsequent treatment plan and predicting disease prognosis.
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Affiliation(s)
- Yutaka Nikkuni
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
| | - Hideyoshi Nishiyama
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takafumi Hyayashi
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Kandathil A, Subramaniam RM. PET/Computed Tomography. PET Clin 2022; 17:235-248. [DOI: 10.1016/j.cpet.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yu H, Lv J, Hu P, Chen S, Shi H. Reduction of radiation accumulation in salivary glands through oral vitamin C during 68Ga-PSMA-11 total-body dynamic PET/CT imaging. Nucl Med Commun 2022; 43:166-171. [PMID: 34864811 DOI: 10.1097/mnm.0000000000001506] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study explored the utility of oral vitamin C in reducing radiation accumulation in the salivary glands during total-body dynamic PET/computed tomography (CT) imaging with 68Ga labeled Prostate-specific membrane antigen (68Ga-PSMA-11). METHODS We enrolled 31 patients who underwent total-body dynamic PET/CT imaging with 68Ga-PSMA-11, of which 11 were given oral vitamin C 30 min after starting the dynamic PET acquisition, whereas the others did not. The volume of interest was automatically segmented on the parotid and submandibular salivary glands once the PET acquisition was completed. The standard uptake value (SUV)mean and its slope during 30-60 min of the acquisition were compared between the trial and control groups. RESULTS The SUVmean of the left and right parotid and submandibular glands in the trial group were 15.37 ± 3.07, 15.03 ± 2.64, 14.92 ± 4.38 and 15.38 ± 4.18, respectively. The respective values of the control group were 19.37 ± 3.82, 20.08 ± 3.55, 22.61 ± 5.62 and 22.73 ± 5.90. The SUVmean slope during 30-60 min of acquisition for the left and right parotid and submandibular glands in the trial group were 0.63 ± 0.13, 0.64 ± 0.14, 0.56 ± 0.25 and 0.62 ± 0.26, respectively. The respective values of the control group were 0.84 ± 0.21, 0.84 ± 0.17, 1.01 ± 0.34 and 1.02 ± 0.37. CONCLUSION Oral vitamin C could reduce the accumulation of radiation in the salivary glands during 68Ga-PSMA-11 total-body dynamic PET/CT imaging.
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Affiliation(s)
- Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University
- Nuclear Medicine Institute of Fudan University
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Jing Lv
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University
- Nuclear Medicine Institute of Fudan University
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Pengcheng Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University
- Nuclear Medicine Institute of Fudan University
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University
- Nuclear Medicine Institute of Fudan University
- Shanghai Institute of Medical Imaging, Shanghai, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University
- Nuclear Medicine Institute of Fudan University
- Shanghai Institute of Medical Imaging, Shanghai, China
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Moon SH, Cho YS, Choi JY. KSNM60 in Clinical Nuclear Oncology. Nucl Med Mol Imaging 2021; 55:210-224. [PMID: 34721714 DOI: 10.1007/s13139-021-00711-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/28/2021] [Accepted: 08/03/2021] [Indexed: 11/28/2022] Open
Abstract
Since the foundation of the Korean Society of Nuclear Medicine in 1961, clinical nuclear oncology has been a major part of clinical nuclear medicine in Korea. There are several important events for the development of clinical nuclear oncology in Korea. First, a scintillating type gamma camera was adopted in 1969, which enabled to perform modern oncological gamma imaging. Second, Tc-99 m generator was imported to Korea since 1979, which promoted the wide clinical use of gamma camera imaging by using various kinds of Tc-99 m labeled radiopharmaceuticals. Third, a gamma camera with single photon emission tomography (SPECT) capability was first installed in 1980, which has been used for various kinds of tumor SPECT imaging. Fourth, in 1994, clinical positron emission tomography (PET) scanner and cyclotron with a production of F-18 fluorodeoxyglucose were first installed in Korea. Fifth, Korean Board of Nuclear Medicine was established in 1995, which contributed in the education and manpower training of dedicated nuclear medicine physicians in Korea. Finally, an integrated PET/CT scanner was first installed in 2002. Since that, PET/CT imaging has been a major imaging tool in clinical nuclear oncology in Korea. In this review, a brief history of clinical nuclear oncology in Korea is described.
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Affiliation(s)
- Seung Hwan Moon
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351 Seoul, Republic of Korea
| | - Young Seok Cho
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351 Seoul, Republic of Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 06351 Seoul, Republic of Korea
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Baratto L, Wu F, Minamimoto R, Hatami N, Liang T, Sabile J, Advani RH, Mittra E. Correlation of 18-fluorodeoxyglucose PET/computed tomography parameters and clinical features to predict outcome for diffuse large B-cell lymphoma. Nucl Med Commun 2021; 42:792-799. [PMID: 33741852 DOI: 10.1097/mnm.0000000000001398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To determine if the correlation between different metabolic parameters along with clinical features can create an improved model of prognostication for diffuse large B-cell lymphoma (DLBCL) patients. METHODS We retrospectively evaluated 89 patients with DLBCL. All patients had a baseline and an interim 18F-FDG PET/CT. Seventy-nine also had an end-of-treatment PET/CT (EOT-PET). For each scan, we collected standardized uptake value (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), SUVmaxsum, SUVmeansum, MTVsum, and TLGsum. These metabolic parameters were combined with clinical features in order to identify a new prognostic model. The predictive value of interim PET and EOT-PET using Deauville score was also determined. RESULTS Baseline SUVmaxsum and SUVmeansum were significantly correlated to overall survival (OS) (P value = 0.012 and 0.011, respectively). The percentage change of MTV and TLG sum from baseline to EOT was predictive of progression-free survival (PFS) (P value = 0.003 and 0.022, respectively). The combination of either Deauville score at the EOT and SUVmaxsum at baseline significantly predicted OS (P value <0.001); Eastern Cooperative Oncology Group performance status, presence of extranodal disease and percentage change of MTVsum from baseline to EOT were significant predictors of PFS (P value = 0.001). CONCLUSIONS SUVmaxsum and SUVmeansum at baseline and percentage change in MTV and TLG sum from baseline to EOT are predictors of outcome in DLBCL patients. These metabolic parameters combined to Deauville score and some clinical features could be used together to stratify patients.
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Affiliation(s)
- Lucia Baratto
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California, USA
| | - Fengyu Wu
- Department of Nuclear Medicine, PET/CT Center, Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ryogo Minamimoto
- Division of Nuclear Medicine, Department of Radiology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Negin Hatami
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California, USA
| | - Tie Liang
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, Stanford, California, USA
| | - Jean Sabile
- Biology Department, University of California, Santa Cruz
| | - Ranjana H Advani
- Division of Medical Oncology, Department of Medicine, Stanford University, Stanford, California
| | - Erik Mittra
- Division of Nuclear Medicine, Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Oregon, USA
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Differentiation between non-small cell lung cancer and radiation pneumonitis after carbon-ion radiotherapy by 18F-FDG PET/CT texture analysis. Sci Rep 2021; 11:11509. [PMID: 34075072 PMCID: PMC8169739 DOI: 10.1038/s41598-021-90674-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 05/10/2021] [Indexed: 12/27/2022] Open
Abstract
The differentiation of non-small cell lung cancer (NSCLC) and radiation pneumonitis (RP) is critically essential for selecting optimal clinical therapeutic strategies to manage post carbon-ion radiotherapy (CIRT) in patients with NSCLC. The aim of this study was to assess the ability of 18F-FDG PET/CT metabolic parameters and its textural image features to differentiate NSCLC from RP after CIRT to develop a differential diagnosis of malignancy and benign lesion. We retrospectively analyzed 18F-FDG PET/CT image data from 32 patients with histopathologically proven NSCLC who were scheduled to undergo CIRT and 31 patients diagnosed with RP after CIRT. The SUV parameters, metabolic tumor volume (MTV), total lesion glycolysis (TLG) as well as fifty-six texture parameters derived from seven matrices were determined using PETSTAT image-analysis software. Data were statistically compared between NSCLC and RP using Wilcoxon rank-sum tests. Diagnostic accuracy was assessed using receiver operating characteristics (ROC) curves. Several texture parameters significantly differed between NSCLC and RP (p < 0.05). The parameters that were high in areas under the ROC curves (AUC) were as follows: SUVmax, 0.64; GLRLM run percentage, 0.83 and NGTDM coarseness, 0.82. Diagnostic accuracy was improved using GLRLM run percentage or NGTDM coarseness compared with SUVmax (p < 0.01). The texture parameters of 18F-FDG uptake yielded excellent outcomes for differentiating NSCLC from radiation pneumonitis after CIRT, which outperformed SUV-based evaluation. In particular, GLRLM run percentage and NGTDM coarseness of 18F-FDG PET/CT images would be appropriate parameters that can offer high diagnostic accuracy.
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Rijo-Cedeño J, Mucientes J, Seijas Marcos S, Romero J, Royuela A, Carbonell S, Benlloch R, García-Berrocal JR. Adding value to tumor staging in head and neck cancer: The role of metabolic parameters as prognostic factors. Head Neck 2021; 43:2477-2487. [PMID: 33955080 DOI: 10.1002/hed.26725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 04/14/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Validated biomarkers in head and neck squamous cell carcinoma (HNSCC) are scarce. METHODS We retrospectively analyzed 62 patients with HNSCC treated with radiotherapy +/- concurrent chemotherapy. Pretreatment metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured in a 18 F-FDG positron emission tomography using a liver dependent standardized uptake value threshold. Cox regression analyses were performed to find associations with disease-free survival (DFS) and overall survival (OS). RESULTS High values of MTV (>37 ml) were independently associated with a worse DFS (hazard ratio [HR] = 3.45; 95% confidence interval [CI], 1.52-7.84) and OS (HR = 3.27; 95% CI, 1.41-7.57). Similar results were found for high values of TLG (>247 g) for DFS (HR = 3.32; 95% CI, 1.44-7.65) and OS (HR = 3.42; 95% CI, 1.45-8.07). CONCLUSIONS MTV and TLG can be considered as independent prognostic factors for DFS and OS in patients with HNSCC. Considering how easily obtainable they are, they may be useful for predicting clinical outcomes in these patients.
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Affiliation(s)
- Jefferson Rijo-Cedeño
- Department of Otorhinolaryngology-Head and Neck Surgery, Puerta de Hierro University Hospital, Madrid, Spain.,Autonomous University of Madrid, Madrid, Spain
| | - Jorge Mucientes
- Department of Nuclear Medicine, Puerta de Hierro University Hospital, Madrid, Spain
| | - Sara Seijas Marcos
- Department of Nuclear Medicine, Puerta de Hierro University Hospital, Madrid, Spain
| | - Jesús Romero
- Department of Radiation Oncology, Puerta de Hierro University Hospital, Madrid, Spain
| | - Ana Royuela
- Biostatistics UnitBiomedical Research Institute IDIPHISA, CIBERESP, Puerta de Hierro University Hospital, Madrid, Spain
| | - Sandra Carbonell
- Department of Otorhinolaryngology-Head and Neck Surgery, Puerta de Hierro University Hospital, Madrid, Spain
| | - Raquel Benlloch
- Department of Radiation Oncology, Puerta de Hierro University Hospital, Madrid, Spain
| | - José Ramón García-Berrocal
- Department of Otorhinolaryngology-Head and Neck Surgery, Puerta de Hierro University Hospital, Madrid, Spain.,Autonomous University of Madrid, Madrid, Spain
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14
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Han F, Li W, Chen T, Yao Y, Li J, Wang D, Wang Z. Ferroptosis-related genes for predicting prognosis of patients with laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2021; 278:2919-2925. [PMID: 33818649 DOI: 10.1007/s00405-021-06789-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/26/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Previous studies reported that ferroptosis-related genes can regulate the process of tumor cell changes by regulating iron metabolism. However, the prognostic value of ferroptosis-related genes in LC remains to be further elucidated. METHODS Ferroptosis-related gene expression profiles of coexisting ferroptosis-related genes were extracted from both cohorts (TCGA and GSE27020) for eligible analysis. LASSO Cox regression was utilized to build an optimum ferroptosis-related prognostic model. Kaplan-Meier curve was performed by log-rank test, and time-dependent ROC curve was constructed to evaluate the predictive power of this signature in both cohorts. GO and KEGG enrichment analysis was used to investigate the potential mechanism of differential enrichment signal pathways. RESULTS 112 LC patients from the TCGA cohort and 108 LC patients with clinical information from the GEO cohorts were eventually included in the study. Three ferroptosis-related genes were identified as an independent risk factor to establish the prognostic risk score. Kaplan-Meier curve represented that patients with high-risk group favors with worse OS than their low-risk group (P = 0.04). The good performance of the gene signature for predicting OS was evaluated by area under the curve (AUC) of time-dependent ROC curves achieved 0.74 at 3 years, and 0.70 at 5 years. Similar performance has been proved in the external validation cohort. GO and KEGG enrichment analysis have been performed to explore the signaling pathways and underlying mechanisms were significantly active in LC patients. CONCLUSION In summary, our study developed a ferroptosis-related model that could be an effective biomarker to predict the prognosis of laryngeal cancer.
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Affiliation(s)
- Fang Han
- Department of Radiology, Affiliated Zhongshan Hospital of DaLian University, Dalian, Liaoning, China.
| | - Wenfei Li
- Department of Radiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Tao Chen
- Department of PET-CT, Xiangyang Central Hospital, Xiangyang, Hubei, China
| | - Yutong Yao
- Department of Radiology, Affiliated Zhongshan Hospital of DaLian University, Dalian, Liaoning, China
| | - Jinglong Li
- Department of Radiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Di Wang
- Department of Endocrine, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
| | - Zhanqiu Wang
- Department of Radiology, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China
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15
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Albano D, Dondi F, Paderno A, Nocivelli G, Maddalo M, Magrini SM, Nicolai P, Maroldi R, Giubbini R, Bertagna F. 18F-FDG-PET/CT in laryngeal cancer: Comparison with conventional imaging and prognostic role. Rev Esp Med Nucl Imagen Mol 2021. [PMID: 33642259 DOI: 10.1016/j.remn.2020.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the diagnostic accuracy of staging 18F-FDG-PET/CT in laryngeal cancer, compare these results with conventional imaging (CI) and assess the value of 18F-FDG-PET/CT features to predict survival. METHODS Fifty-four patients with laryngeal squamous cell cancer and baseline 18F-FDG-PET/CT were retrospectively enrolled. The PET images were analyzed visually and semi-quantitatively by measuring several metabolic parameters. A combination of clinical follow-up/imaging follow-up and/or histopathology was taken as reference standard. Progression free survival (PFS) and disease specific survival (DSS) were computed using Kaplan-Meier curves. RESULTS All primary tumors were clearly identified by CI, and 52/54 by 18F-FDG-PET/CT with a sensitivity of 96.3%. Cervical nodal metastases were detected in 40/54 patients at 18F-FDG-PET/CT and in 34/49 patients at CI. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy on a patient-based analysis for nodal disease were 100%, 85.7%, 94.6%, 100% and 95.9% at 18F-FDG-PET/CT, and 91.4%, 85.7%, 94.1%, 80%, 89.8% at CI. Diagnostic performances of PET/CT and CI were not significantly different on a patient-based, side-by-side and level-by-level analysis. 18F-FDG-PET/CT recognized distant metastases in 7 patients allowing to an upstaging. At a median follow-up of 27 months, relapse/progression of disease occurred in 31 patients and death occurred in 32. Metabolic tumor volume (MTV T), MTV total and total lesion glycolysis (TLG) showed to be independent prognostic factors for PFS. CONCLUSIONS Both CI and PET/CT had good diagnostic performances for the staging of laryngeal cancer; baseline metabolic features (MTV and TLG) showed an important prognostic value in assessing the rate of PFS.
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Affiliation(s)
- D Albano
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia.
| | - F Dondi
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - A Paderno
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - G Nocivelli
- Department of Radiology, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - M Maddalo
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italia
| | - S M Magrini
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italia
| | - P Nicolai
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - R Maroldi
- Department of Radiology, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - R Giubbini
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia
| | - F Bertagna
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italia
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Subramaniam N, Poptani H, Schache A, Bhat V, Iyer S, Sunil HV, Chandrasekhar N, Pillai V, Chaturvedi P, Krishna S, Krishnamurthy A, Kekatpure V, Kuriakose M, Iyer NG, Thakkar A, Kantharia R, Sonkar A, Shetty V, Rangappa V, Kolur T, Vidhyadharan S, Murthy S, Kudpaje A, Srinivasalu V, Mahajan A. Imaging advances in oral cavity cancer and perspectives from a population in need: Consensus from the UK-India oral cancer imaging group. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2021. [DOI: 10.4103/jhnps.jhnps_10_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Zhong J, Frood R, Brown P, Nelstrop H, Prestwich R, McDermott G, Currie S, Vaidyanathan S, Scarsbrook AF. Machine learning-based FDG PET-CT radiomics for outcome prediction in larynx and hypopharynx squamous cell carcinoma. Clin Radiol 2020; 76:78.e9-78.e17. [PMID: 33036778 DOI: 10.1016/j.crad.2020.08.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/24/2020] [Indexed: 12/24/2022]
Abstract
AIM To determine whether machine learning-based radiomic feature analysis of baseline integrated 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET) computed tomography (CT) predicts disease progression in patients with locally advanced larynx and hypopharynx squamous cell carcinoma (SCC) receiving (chemo)radiotherapy. MATERIALS AND METHODS Patients with larynx and hypopharynx SCC treated with definitive (chemo)radiotherapy at a specialist cancer centre undergoing pre-treatment PET-CT between 2008 and 2017 were included. Tumour segmentation and radiomic analysis was performed using LIFEx software (University of Paris-Saclay, France). Data were assigned into training (80%) and validation (20%) cohorts adhering to TRIPOD guidelines. A random forest classifier was created for four predictive models using features determined by recursive feature elimination: (A) PET, (B) CT, (C) clinical, and (D) combined PET-CT parameters. Model performance was assessed using area under the curve (AUC) receiver operating characteristic (ROC) analysis. RESULTS Seventy-two patients (40 hypopharynx 32 larynx tumours) were included, mean age 61 (range 41-77) years, 50 (69%) were men. Forty-five (62.5%) had chemoradiotherapy, 27 (37.5%) had radiotherapy alone. Median follow-up 26 months (range 12-105 months). Twenty-seven (37.5%) patients progressed within 12 months. ROC AUC for models A, B, C, and D were 0.91, 0.94, 0.88, and 0.93 in training and 0.82, 0.72, 0.70, and 0.94 in validation cohorts. Parameters in model D were metabolic tumour volume (MTV), maximum CT value, minimum standardized uptake value (SUVmin), grey-level zone length matrix (GLZLM) small-zone low grey-level emphasis (SZLGE) and histogram kurtosis. CONCLUSION FDG PET-CT derived radiomic features are potential predictors of early disease progression in patients with locally advanced larynx and hypopharynx SCC.
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Affiliation(s)
- J Zhong
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | - R Frood
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - P Brown
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - H Nelstrop
- Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - R Prestwich
- Department of Clinical Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - G McDermott
- Department of Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S Currie
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Radiotherapy Research Group, Leeds Institute of Medical Research, Faculty of Medicine & Health, University of Leeds, Leeds, UK
| | - S Vaidyanathan
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A F Scarsbrook
- Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Radiotherapy Research Group, Leeds Institute of Medical Research, Faculty of Medicine & Health, University of Leeds, Leeds, UK
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18
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A Novel Prognostic Index Based on the Analysis of Glycolysis-Related Genes in Head and Neck Squamous Cell Carcinomas. JOURNAL OF ONCOLOGY 2020; 2020:7353874. [PMID: 33029143 PMCID: PMC7532401 DOI: 10.1155/2020/7353874] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/29/2020] [Indexed: 12/24/2022]
Abstract
Aims The preferential dependence on glycolysis as a pathway of energy metabolism is a hallmark of cancer cells. However, the prognostic significance of glycolysis-related genes in head and neck squamous cell carcinoma (HNSCC) remains obscure. The purpose of this study was to identify glycolysis-related genes of prognostic value in HNSCC. Results Transcriptional and clinical data of 544 HNSCC samples were obtained from The Cancer Genome Atlas (TCGA) dataset. By gene set enrichment analysis (GSEA) and by employing a univariate and subsequently a stepwise multivariate Cox proportional regression model, eight glycolysis-related genes of prognostic significance in HNSCC (KIF2A, JMJD8, HMMR, STC2, HK1, EXT2, GPR8, and STC1) were identified. The patients were clustered into two groups (high and low risk) based on the expression of these genes. High-risk patients had significantly a shorter overall survival than low-risk patients. Furthermore, a new prognostic indicator based on selected glycolysis-related genes was developed by multivariate Cox analysis that proved to be a better predictor of patient outcome compared to other clinical factors. Conclusion Our findings provide new insights into the role of glycolysis in HNSCC. The identified genes predict the patient prognosis and might substantially contribute to the development of individualized treatments.
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Magnetic resonance imaging-derived radiomic signature predicts locoregional failure after organ preservation therapy in patients with hypopharyngeal squamous cell carcinoma. Clin Transl Radiat Oncol 2020; 25:1-9. [PMID: 33426314 PMCID: PMC7780126 DOI: 10.1016/j.ctro.2020.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/16/2020] [Accepted: 08/24/2020] [Indexed: 01/08/2023] Open
Abstract
The first study to develop and validate an MRI-derived radiomic signature (RS) for the prediction of 1-year locoregional failure in HPSCC patients receiving OPT. The RS-based model (RS of 0.0326 as the cut-off value) provides a novel and convenient approach for the prediction of the 1-year clinical outcomes. The proposed RS-based model can help physicians characterize and facilitate decision-making for the clinical management of patients with locally advanced HPSCC.
Background and purpose To develop and validate a magnetic resonance imaging (MRI)-derived radiomic signature (RS) for the prediction of 1-year locoregional failure (LRF) in patients with hypopharyngeal squamous cell carcinoma (HPSCC) who received organ preservation therapy (OPT) Material and methods A total of 800 MRI-based features of pretreatment tumors were obtained from 116 patients with HPSCC who received OPT from two independent cohorts. The least absolute shrinkage and selection operator regression model were used to select the features used to develop the RS. Harrell’s C-index and corrected C-index were used to evaluate the discriminative ability of RS. The Youden index was used to select the optimal cut-point for risk category. Results The RS yielded 1000 times bootstrapping corrected C-index of 0.8036 and 0.78235 in the experimental (n = 82) and validation cohorts (n = 34), respectively. With respect to the subgroup of patients with stage III/IV and cT4 disease, the RS also showed good predictive performance with corrected C-indices of 0.760 and 0.754, respectively. The dichotomized risk category using an RS of 0.0326 as the cut-off value yielded a 1-year LRF predictive accuracy of 79.27%, 79.41%, 76.74%, and 71.15% in the experimental, validation, stage III/IV, and cT4a cohorts, respectively. The low-risk group was associated with a significantly better progression-free laryngectomy-free and overall survival outcome in two independent institutions, stage III/IV, and cT4a cohorts. Conclusion The RS-based model provides a novel and convenient approach for the prediction of the 1-year LRF and survival outcome in patients with HPSCC who received OPT.
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Albano D, Dondi F, Paderno A, Nocivelli G, Maddalo M, Magrini SM, Nicolai P, Maroldi R, Giubbini R, Bertagna F. 18F-FDG-PET/CT in laryngeal cancer: comparison with conventional imaging and prognostic role. Rev Esp Med Nucl Imagen Mol 2020; 40:229-238. [PMID: 34218885 DOI: 10.1016/j.remnie.2020.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 06/08/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the diagnostic accuracy of staging 18 F-FDG-PET/CT in laryngeal cancer, compare these results with conventional imaging (CI) and assess the value of 18 F-FDG-PET/CT features to predict survival. METHODS Fifty-four patients with laryngeal squamous cell cancer and baseline 18 F-FDG-PET/CT were retrospectively enrolled. The PET images were analyzed visually and semi-quantitatively by measuring several metabolic parameters. A combination of clinical follow-up/imaging follow-up and/or histopathology was taken as reference standard. Progression free survival (PFS) and disease specific survival (DSS) were computed using Kaplan-Meier curves. RESULTS All primary tumors were clearly identified by CI, and 52/54 by 18 F-FDG-PET/CT with a sensitivity of 96.3%. Cervical nodal metastases were detected in 40/54 patients at 18 F-FDG-PET/CT and in 34/49 patients at CI. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy on a patient-based analysis for nodal disease were 100%, 85.7%, 94.6%, 100% and 95.9% at 18 F-FDG-PET/CT, and 91.4%, 85.7%, 94.1%, 80%, 89.8% at CI. Diagnostic performances of PET/CT and CI were not significantly different on a patient-based, side-by-side and level-by-level analysis. 18 F-FDG-PET/CT recognized distant metastases in 7 patients allowing to an upstaging. At a median follow-up of 27 months, relapse/progression of disease occurred in 31 patients and death occurred in 32. Metabolic tumor volume (MTV T), MTV total and total lesion glycolysis (TLG) showed to be independent prognostic factors for PFS. CONCLUSIONS Both CI and PET/CT had good diagnostic performances for the staging of laryngeal cancer; baseline metabolic features (MTV and TLG) showed an important prognostic value in assessing the rate of PFS.
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Affiliation(s)
- Domenico Albano
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy.
| | - Francesco Dondi
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Alberto Paderno
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Giorgio Nocivelli
- Department of Radiology, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Marta Maddalo
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italy
| | - Stefano Maria Magrini
- Department of Radiation Oncology, University of Brescia and Spedali Civili, Brescia, Italy
| | - Piero Nicolai
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Roberto Maroldi
- Department of Radiology, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Raffaele Giubbini
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
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Wang C, Zhao K, Hu S, Huang Y, Ma L, Song Y, Li M. A predictive model for treatment response in patients with locally advanced esophageal squamous cell carcinoma after concurrent chemoradiotherapy: based on SUVmean and NLR. BMC Cancer 2020; 20:544. [PMID: 32522277 PMCID: PMC7288413 DOI: 10.1186/s12885-020-07040-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 06/04/2020] [Indexed: 02/06/2023] Open
Abstract
Background We conducted this study to combine the mean standardized uptake value (SUVmean) and neutrophil to lymphocyte ratio (NLR) to establish a strong predictive model for patients with esophageal squamous cell carcinoma (ESCC) after concurrent chemoradiotherapy (CCRT). Methods We retrospectively analyzed 163 newly diagnosed ESCC patients treated with CCRT. Eighty patients (training set) were randomly selected to generate cut-off SUVmean and NLR values by receiver operating characteristic (ROC) curve analysis and to establish a predictive model by using the independent predictors of treatment outcomes. Then, we evaluated the performance of the prediction model regarding treatment outcomes in the testing set (n = 83) and in all sets. Results A high SUVmean (> 5.81) and high NLR (> 2.42) at diagnosis were associated with unfavorable treatment outcomes in patients with ESCC. The prediction model had a better performance than the simple parameters (p < 0.05). With a cut-off value of 0.77, the prediction model significantly improved the specificity and positive predictive value for treatment response (88.9 and 92.1% in the training set, 95.8 and 97.1% in the testing set, and 92.2 and 91.8% in all sets, respectively). Conclusions The pretreatment SUVmean and NLR were independent predictors of treatment response in ESCC patients treated with CCRT. The predictive model was constructed based on these two parameters and provides a highly accurate tool for predicting patient outcomes.
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Affiliation(s)
- Chunsheng Wang
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, 20 Yudong Road, Yantai, 264000, Shandong, People's Republic of China
| | - Kewei Zhao
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, 20 Yudong Road, Yantai, 264000, Shandong, People's Republic of China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, People's Republic of China
| | - Shanliang Hu
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, 20 Yudong Road, Yantai, 264000, Shandong, People's Republic of China
| | - Yong Huang
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, People's Republic of China
| | - Li Ma
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, People's Republic of China
| | - Yipeng Song
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, 20 Yudong Road, Yantai, 264000, Shandong, People's Republic of China
| | - Minghuan Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, People's Republic of China.
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22
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Delaby G, Hubaut MA, Morschhauser F, Besson A, Huglo D, Herbaux C, Baillet C. Prognostic value of the metabolic bulk volume in patients with diffuse large B-cell lymphoma on baseline 18F-FDG PET-CT. Leuk Lymphoma 2020; 61:1584-1591. [DOI: 10.1080/10428194.2020.1728750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Gauthier Delaby
- Service de médecine nucléaire, Université de Lille, Lille, France
| | | | | | - Alix Besson
- Service de médecine nucléaire, Université de Lille, Lille, France
| | - Damien Huglo
- Service de médecine nucléaire, Université de Lille, Lille, France
| | - Charles Herbaux
- Service des Maladies du Sang, Université de Lille, Lille, France
| | - Clio Baillet
- Service de médecine nucléaire, Université de Lille, Lille, France
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Prognostic value of 18F-FDG PET/CT parameters and histopathologic variables in head and neck cancer. Braz J Otorhinolaryngol 2019; 87:452-456. [PMID: 31899125 PMCID: PMC9422361 DOI: 10.1016/j.bjorl.2019.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/28/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters such as; maximum standardized uptake values, standard metabolic tumor volume and otal lesion glycosis are important prognostic biomarkers in cancers. OBJECTIVE To investigate the prognostic value of these parameters in patients with head and neck cancers. METHODS We performed a retrospective study including 47 patients with head and neck cancer who underwent18F-fluorodeoxyglucose positron emission tomography/computed tomography prior to treatment. Standard metabolic tumor volume, otal lesion glycosis and standardized uptake were measured for each patient. The prognostic value of quantitative 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters and clinicopathologic variables on disease free survival and overall survival were analyzed. RESULTS The median (range) standard metabolic tumor volume and otal lesion glycosis and standardized uptake were 7.63cm3 (0.6-34.3), 68.9g (2.58-524.5g), 13.89 (4.89-33.03g/mL), respectively. Lymph node metastases and tumour differentiation were significant variables for disease free survival and overall survival, however, all 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters were not associated with disease- free survival and overall survival. CONCLUSION Pretreatment quantities positron emission tomography parameters did not predict survival in head and neck cancer.
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18F-FDG-PET/CT Imaging in Advanced Glottic Cancer: A Tool for Clinical Decision in Comparison with Conventional Imaging. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:4051206. [PMID: 31558887 PMCID: PMC6755300 DOI: 10.1155/2019/4051206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/08/2019] [Accepted: 07/07/2019] [Indexed: 11/17/2022]
Abstract
This study assessed the role of 18F-FDG PET-CT (PET/CT) to detect the cartilage and paraglottic infiltration in advanced glottic cancer comparing the results with those of conventional imaging (CI) (contrast-enhanced computed tomography and/or magnetic resonance). In addition, we assessed the prognostic value of quantitative parameters, measured on baseline PET/CT, in terms of event-free survival (EFS) and overall survival (OS). We retrospectively analyzed 27 patients with glottic squamous cell carcinoma stage III and IVA, treated in our institute between 2010 and 2016, comparing PET/CT, performed for staging and radiotherapy planning, and CI findings. Cohen's K was used to compare concordance between PET/CT and CI. Imaging findings were correlated with endoscopic evaluation and histological reports (gold standard (GS)). All lesions shown by CI were also detected by PET/CT imaging, and in 5 cases, a better definition of local infiltration was achieved with PET/CT than CI (5 CT). Sensitivity, specificity, and accuracy of PET/CT and CT were 95%, 86%, and 93% and 70%, 86%, and 74% for, respectively. MRI showed sensitivity and specificity of 100%. One false-negative (FN) cases and 1 false-positive (FP) case were observed with PET/CT with no difference compared to MRI (10 cases). Six FN cases and 1 FP case were observed with CT. Cohen's K was 0.60 (PET vs. CI) and 0.80 (PET vs. GS). Patients were followed-up for at least 24 months to calculate EFS and OS. 13 local recurrence and 7 deaths were recorded. Among quantitative PET parameters, baseline MTV was the most powerful predictor of outcome. Our data suggest a reliable sensitivity and accuracy of PET/CT in the evaluation of local extension, proving a useful method for initial local staging in addition to the well-established role in lymph-node and distant sites assessment. Furthermore, pretreatment MTV provides better prognostic information than other PET/CT parameters.
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Targeting Cellular Metabolism Modulates Head and Neck Oncogenesis. Int J Mol Sci 2019; 20:ijms20163960. [PMID: 31416244 PMCID: PMC6721038 DOI: 10.3390/ijms20163960] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/12/2019] [Accepted: 08/13/2019] [Indexed: 12/24/2022] Open
Abstract
Considering the great energy and biomass demand for cell survival, cancer cells exhibit unique metabolic signatures compared to normal cells. Head and neck squamous cell carcinoma (HNSCC) is one of the most prevalent neoplasms worldwide. Recent findings have shown that environmental challenges, as well as intrinsic metabolic manipulations, could modulate HNSCC experimentally and serve as clinic prognostic indicators, suggesting that a better understanding of dynamic metabolic changes during HNSCC development could be of great benefit for developing adjuvant anti-cancer schemes other than conventional therapies. However, the following questions are still poorly understood: (i) how does metabolic reprogramming occur during HNSCC development? (ii) how does the tumorous milieu contribute to HNSCC tumourigenesis? and (iii) at the molecular level, how do various metabolic cues interact with each other to control the oncogenicity and therapeutic sensitivity of HNSCC? In this review article, the regulatory roles of different metabolic pathways in HNSCC and its microenvironment in controlling the malignancy are therefore discussed in the hope of providing a systemic overview regarding what we knew and how cancer metabolism could be translated for the development of anti-cancer therapeutic reagents.
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Werner J, Hüllner MW, Rupp NJ, Huber AM, Broglie MA, Huber GF, Morand GB. Predictive Value of Pretherapeutic Maximum Standardized Uptake Value (Suv max) In Laryngeal and Hypopharyngeal Cancer. Sci Rep 2019; 9:8972. [PMID: 31222167 PMCID: PMC6586936 DOI: 10.1038/s41598-019-45462-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/07/2019] [Indexed: 12/15/2022] Open
Abstract
The aim of the study was to evaluate whether pretherapeutic metabolic tumor parameters from 18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging could predict larynx preservation in laryngeal and hypopharyngeal cancer patients prior to primary chemoradiation. Tumor metabolic parameters [maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were retrospectively assessed in a consecutive cohort of laryngeal and hypopharyngeal cancer patients undergoing primary (chemo-)radiation. Main outcome measures were larynx preservation and survival. The study included 97 patients with a median follow-up of 32 months (IQR 20-54.5). For hypopharyngeal cancer, multivariable analysis showed that patients with a primary tumor's SUVmax > 9.5 entailed a higher risk of undergoing salvage pharyngolaryngectomy after chemoradiation (HR = 8.64, 95% CI = 1.1-67.3, P = 0.040). In laryngeal cancer, SUVmax did not predict the need for salvage laryngectomy. The only predictor for larynx preservation in laryngeal cancer patients was T-classification at initial diagnosis (HR = 6.67, 95% CI = 0.82-53.9, P = 0.039). In conclusion, SUVmax of primary tumor could be used as a predictor of larynx preservation prior to primary chemoradiation in hypopharyngeal cancer patients. This information may be important for patient counseling, as high SUVmax was correlated with reduced probability of larynx preservation. However, in laryngeal cancer patients, SUVmax does not seem to be predictive of outcome.
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Affiliation(s)
- Jonas Werner
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martin W Hüllner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Alexander M Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Martina A Broglie
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Gerhard F Huber
- Department of Otorhinolaryngology - Head and Neck Surgery, Kantonsspital St. Gallen, St. Gallen, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Grégoire B Morand
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. .,University of Zurich, Zurich, Switzerland.
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27
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Subramaniam N, Balasubramanian D, Reddy R, Thankappan K, Iyer S. Organ Preservation Protocols in T4 Laryngeal Cancer: a Review of the Literature. Indian J Surg Oncol 2019; 10:149-155. [PMID: 30948891 DOI: 10.1007/s13193-018-0840-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 11/23/2018] [Indexed: 11/29/2022] Open
Abstract
Population-based studies indicate that chemoradiation has become the most popular treatment for advanced laryngeal cancers; however, by extrapolating trial results to the general population, several issues have emerged, such as reduced overall survival, non-functional laryngeal preservation, and poor response to treatment. Although included in these trials, T4 laryngeal and hypopharyngeal cancers with cartilage invasion formed a small percentage of these patients and questions over whether they were appropriately staged remain unanswered. Literature on the use of chemoradiation in this set of patients, including the challenges, treatment considerations, and factors predicting response to treatment and outcomes, was reviewed. Current evidence indicates that all patients of T4 laryngeal and hypopharyngeal cancer are not suitable candidates for organ preservation; this modality should be offered only to select patients with good performance status and access to rehabilitative care and regular follow-up in order to achieve good results.
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Affiliation(s)
- Narayana Subramaniam
- 1Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Deepak Balasubramanian
- 1Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Rithvik Reddy
- 2Department of Surgery, Royal North Shore Hospital, University of Sydney, Sydney, Australia
| | - Krishnakumar Thankappan
- 1Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Subramania Iyer
- 1Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
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Rahmim A, Bak-Fredslund KP, Ashrafinia S, Lu L, Schmidtlein CR, Subramaniam RM, Morsing A, Keiding S, Horsager J, Munk OL. Prognostic modeling for patients with colorectal liver metastases incorporating FDG PET radiomic features. Eur J Radiol 2019; 113:101-109. [PMID: 30927933 DOI: 10.1016/j.ejrad.2019.02.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 12/22/2018] [Accepted: 02/04/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE We aimed to improve prediction of outcome for patients with colorectal liver metastases, via prognostic models incorporating PET-derived measures, including radiomic features that move beyond conventional standard uptake value (SUV) measures. PATIENTS AND METHODS A range of parameters including volumetric and heterogeneity measures were derived from FDG PET images of 52 patients with colorectal intrahepatic-only metastases (29 males and 23 females; mean age 62.9 years [SD 9.8; range 32-82]). The patients underwent PET/CT imaging as part of the clinical workup prior to final decision on treatment. Univariate and multivariate models were implemented, which included statistical considerations (to discourage false discovery and overfitting), to predict overall survival (OS), progression-free survival (PFS) and event-free survival (EFS). Kaplan-Meier survival analyses were performed, where the subjects were divided into high-risk and low-risk groups, from which the hazard ratios (HR) were computed via Cox proportional hazards regression. RESULTS Commonly-invoked SUV metrics performed relatively poorly for different prediction tasks (SUVmax HR = 1.48, 0.83 and 1.16; SUVpeak HR = 2.05, 1.93, and 1.64, for OS, PFS and EFS, respectively). By contrast, the number of liver metastases and metabolic tumor volume (MTV) each performed well (with respective HR values of 2.71, 2.61 and 2.42, and 2.62, 1.96 and 2.29, for OS, PFS and EFS). Total lesion glycolysis (TLG) also resulted in similar performance as MTV. Multivariate prognostic modeling incorporating different features (including those quantifying intra-tumor heterogeneity) resulted in further enhanced prediction. Specifically, HR values of 4.29, 4.02 and 3.20 (p-values = 0.00004, 0.0019 and 0.0002) were obtained for OS, PFS and EFS, respectively. CONCLUSIONS PET-derived measures beyond commonly invoked SUV parameters hold significant potential towards improved prediction of clinical outcome in patients with liver metastases, especially when utilizing multivariate models.
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Affiliation(s)
- Arman Rahmim
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA; Departments of Radiology and Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada.
| | | | - Saeed Ashrafinia
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA; Department of Electrical & Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Lijun Lu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - C Ross Schmidtlein
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rathan M Subramaniam
- Department of Radiology, University of Texas Southwestern Medical Center, TX, USA
| | - Anni Morsing
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Susanne Keiding
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Jacob Horsager
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
| | - Ole L Munk
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
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Subramaniam N, Balasubramanian D, Sundaram PS, Murthy S, Thankappan K, Iyer S. Role of pretreatment fluorodeoxyglucose positron emission tomography quantitative parameters in prognostication of head-and-neck squamous cell carcinoma. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_253_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
In spite of the good organ preservation strategies available for locally advanced head-and-neck squamous cell carcinoma (HNSCC), failure rates have been reported to be as high as 35%–50%. There has been an increasing interest in predicting response to treatment, to aid early intervention and better outcomes. Fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET) is a standard modality for posttreatment evaluation; however, it is still underutilized as a pretreatment investigative modality. Several articles have described quantitative parameters in pretreatment FDG-PET to prognosticate patients and determine the likelihood of response to treatment; however, they are still not used commonly. This article was a review of the literature available on pretreatment FDG-PET quantitative parameters and their value in predicting failure. A thorough review of literature from MEDLINE and EMBASE was performed on pretreatment quantitative parameters in HNSCC. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were reliable parameters to predict response to organ preservation therapy, disease-free survival, and overall survival. Maximum SUV (SUVmax) was an inconsistent parameter. MTV and TLG may help predict poor response to organ preservation to initiate early surgical salvage or modify therapeutic decisions to optimize clinical outcomes. Routine use may provide additional information over SUVmax alone.
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Affiliation(s)
- Narayana Subramaniam
- Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Deepak Balasubramanian
- Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - P Shanmuga Sundaram
- Department of Nuclear Medicine, Amrita Institute of Medical Sciences, Amrita Vidya Vidyapeetham, Kochi, Kerala, Indias
| | - Samskruthi Murthy
- Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Krishnakumar Thankappan
- Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Subramania Iyer
- Department of Head and Neck Oncology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Okazaki E, Kawabe J, Oishi M, Hosono M, Higashiyama S, Teranishi Y, Shiomi S, Iguchi H, Miki Y. Prognostic significance of pretreatment 18F-fluorodeoxyglucose positron emission tomography evaluation using metabolic tumor volume of the primary tumor and lymph nodes in advanced hypopharyngeal cancer. Head Neck 2018; 41:739-747. [PMID: 30536887 DOI: 10.1002/hed.25429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/02/2018] [Accepted: 09/21/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The purpose of this study was to retrospectively evaluate the usefulness of pretreatment positron emission tomography (PET) using metabolic tumor volume (MTV) of the primary tumor and lymph nodes in advanced hypopharyngeal cancer. METHODS From June 2007 to December 2015, consecutive patients with advanced hypopharyngeal cancer who underwent PET and were treated with definitive radiation therapy were retrospectively reviewed. RESULTS A total of 61 patients were eligible for this study. On multivariate analysis, MTV of the primary tumor (MTV-T) was significantly related to the local control rate and overall survival (OS) (P = .036 and .012, respectively). In patients with lower MTV-T, MTV of metastatic lymph nodes (MTV-N) was significantly related to disease-specific survival and OS (P = .012 and .017, respectively). CONCLUSION MTV-T is a significant predictor in patients with advanced hypopharyngeal cancer, and MTV-N is also significant in patients with lower MTV-T.
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Affiliation(s)
- Eiichiro Okazaki
- Department of Radiation Oncology, Saiseikai Nakatsu Hospital, Osaka, Japan.,Department of Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Joji Kawabe
- Department of Nuclear Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masahiro Oishi
- Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masako Hosono
- Department of Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shigeaki Higashiyama
- Department of Nuclear Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yuichi Teranishi
- Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Susumu Shiomi
- Department of Nuclear Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hiroyoshi Iguchi
- Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Bonomo P, Merlotti A, Olmetto E, Bianchi A, Desideri I, Bacigalupo A, Franco P, Franzese C, Orlandi E, Livi L, Caini S. What is the prognostic impact of FDG PET in locally advanced head and neck squamous cell carcinoma treated with concomitant chemo-radiotherapy? A systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 2018; 45:2122-2138. [PMID: 29948105 PMCID: PMC6182396 DOI: 10.1007/s00259-018-4065-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/10/2018] [Indexed: 01/22/2023]
Abstract
PURPOSE Evidence is conflicting on the prognostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in head and neck squamous cell carcinoma. The aim of our study was to determine the impact of semiquantitative and qualitative metabolic parameters on the outcome in patients managed with standard treatment for locally advanced disease. METHODS A systematic review of the literature was conducted. A meta-analysis was performed of studies providing estimates of relative risk (RR) for the association between semiquantitative metabolic parameters and efficacy outcome measures. RESULTS The analysis included 25 studies, for a total of 2,223 subjects. The most frequent primary tumour site was the oropharynx (1,150/2,223 patients, 51.7%). According to the available data, the majority of patients had stage III/IV disease (1,709/1,799, 94.9%; no information available in four studies) and were treated with standard concurrent chemoradiotherapy (1,562/2,009 patients, 77.7%; only one study without available information). A total of 11, 8 and 4 independent studies provided RR estimates for the association between baseline FDG PET metrics and overall survival (OS), progression-free survival (PFS) and locoregional control (LRC), respectively. High pretreatment metabolic tumour volume (MTV) was significantly associated with a worse OS (summary RR 1.86, 95% CI 1.08-3.21), PFS (summary RR 1.81, 95% CI 1.14-2.89) and LRC (summary RR 3.49, 95% CI 1.65-7.35). Given the large heterogeneity (I2 > 50%) affecting the summary measures, no cumulative threshold for an unfavourable prognosis could be defined. No statistically significant association was found between SUVmax and any of the outcome measures. CONCLUSION FDG PET has prognostic relevance in the context of locally advanced head and neck squamous cell carcinoma. Pretreatment MTV is the only metabolic variable with a significant impact on patient outcome. Because of the heterogeneity and the lack of standardized methodology, no definitive conclusions on optimal cut-off values can be drawn.
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Affiliation(s)
- Pierluigi Bonomo
- Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy.
| | - A Merlotti
- Radiation Oncology, Azienda Ospedaliera S.Croce e Carle, Cuneo, Italy
| | - E Olmetto
- Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - A Bianchi
- Nuclear Medicine Department, Azienda Ospedaliera S.Croce e Carle, Cuneo, Italy
| | - I Desideri
- Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - A Bacigalupo
- Radiation Oncology Department, Ospedale Policlinico San Martino, Genoa, Italy
| | - P Franco
- Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy
| | - C Franzese
- Department of Radiotherapy and Radiosurgery, Humanitas Cancer Center and Research Hospital, Rozzano, Italy
| | - E Orlandi
- Radiotherapy 2 Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Livi
- Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, largo Brambilla 3, 50134, Florence, Italy
| | - S Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Cancer Research and Prevention Institute (ISPO), Florence, Italy
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Ketabi A, Ghafarian P, Mosleh-Shirazi MA, Mahdavi SR, Rahmim A, Ay MR. Impact of image reconstruction methods on quantitative accuracy and variability of FDG-PET volumetric and textural measures in solid tumors. Eur Radiol 2018; 29:2146-2156. [PMID: 30280249 DOI: 10.1007/s00330-018-5754-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/20/2018] [Accepted: 09/11/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aims to assess the impact of different image reconstruction methods on PET/CT quantitative volumetric and textural parameters and the inter-reconstruction variability of these measurements. METHODS A total of 25 oncology patients with 65 lesions (between 2017 and 2018) and a phantom with signal-to-background ratios (SBR) of 2 and 4 were included. All images were retrospectively reconstructed using OSEM, PSF only, TOF only, and TOFPSF with 3-, 5-, and 6.4-mm Gaussian filters. The metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured. The relative percent error (ΔMTV and ΔTLG) with respect to true values, volume recovery coefficients, and Dice similarity coefficient, as well as inter-reconstruction variabilities were quantified and assessed. In clinical scans, textural features (coefficient of variation, skewness, and kurtosis) were determined. RESULTS Among reconstruction methods, mean ΔMTV differed by -163.5 ± 14.1% to 6.3 ± 6.2% at SBR2 and -42.7 ± 36.7% to 8.6 ± 3.1 at SBR4. Dice similarity coefficient significantly increased by increasing SBR from 2 to 4, ranging from 25.7 to 83.4% between reconstruction methods. Mean ΔTLG was -12.0 ± 1.7 for diameters > 17 mm and -17.8 ± 7.8 for diameters ≤ 17 mm at SBR4. It was -31.7 ± 4.3 for diameters > 17 mm and -14.2 ± 5.8 for diameters ≤ 17 mm at SBR2. Textural features were prone to variations by reconstruction methods (p < 0.05). CONCLUSIONS Inter-reconstruction variability was significantly affected by the target size, SBR, and cut-off threshold value. In small tumors, inter-reconstruction variability was noteworthy, and quantitative parameters were strongly affected. TOFPSF reconstruction with small filter size produced greater improvements in performance and accuracy in quantitative PET/CT imaging. KEY POINTS • Quantitative volumetric PET evaluation is critical for the analysis of tumors. • However, volumetric and textural evaluation is prone to important variations according to different image reconstruction settings. • TOFPSF reconstruction with small filter size improves quantitative analysis.
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Affiliation(s)
- Ali Ketabi
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Pardis Ghafarian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,PET/CT and Cyclotron Center, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Amin Mosleh-Shirazi
- Ionizing and Nonionizing Radiation Protection Research Center and Department of Radio-Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Rabi Mahdavi
- Department of Medical Physics, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Arman Rahmim
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, USA.,Departments of Radiology and Physics & Astronomy, University of British Columbia, Vancouver, BC, Canada
| | - Mohammad Reza Ay
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. .,Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran.
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Lee JR, Almuhaimid TM, Roh JL, Oh JS, Kim SJ, Kim JS, Choi SH, Nam SY, Kim SY. Prognostic value of 18
F-FDG PET/CT parameters in patients who undergo salvage treatments for recurrent squamous cell carcinoma of the larynx and hypopharynx. J Surg Oncol 2018; 118:644-650. [DOI: 10.1002/jso.25185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Jae Ryung Lee
- Department of Otolaryngology-Head & Neck Surgery; Keimyung University Dongsan Medical Center; Daegu Korea
| | - Turki M. Almuhaimid
- Department of Surgery; King Fahad Specialist Hospital; Dammam Saudi Arabia
- Department of Otolaryngology; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| | - Jong-Lyel Roh
- Department of Otolaryngology; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| | - Jungsu S. Oh
- Department of Nuclear Medicine; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| | - Soo-Jong Kim
- Department of Nuclear Medicine; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| | - Jae Seung Kim
- Department of Nuclear Medicine; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| | - Seung-Ho Choi
- Department of Otolaryngology; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| | - Soon Yuhl Nam
- Department of Otolaryngology; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
| | - Sang Yoon Kim
- Department of Otolaryngology; Asan Medical Center, University of Ulsan College of Medicine; Seoul Korea
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PET-based prognostic survival model after radiotherapy for head and neck cancer. Eur J Nucl Med Mol Imaging 2018; 46:638-649. [DOI: 10.1007/s00259-018-4134-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/13/2018] [Indexed: 12/23/2022]
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35
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Robin P, Bourhis D, Bernard B, Abgral R, Querellou S, Le Duc-Pennec A, Le Roux PY, Salaün PY. Feasibility of Systematic Respiratory-Gated Acquisition in Unselected Patients Referred for 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography. Front Med (Lausanne) 2018. [PMID: 29516001 PMCID: PMC5826069 DOI: 10.3389/fmed.2018.00036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective Respiratory motion in 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) induces blurred images, leading to errors in location and quantification for lung and abdominal lesions. Various methods have been developed to correct for these artifacts, and most of current PET/CT scanners are equipped with a respiratory gating system. However, they are not routinely performed because their use is time-consuming. The aim of this study is to assess the feasibility and quantitative impact of a systematic respiratory-gated acquisition in unselected patients referred for FDG PET/CT, without increasing acquisition time. Methods Patients referred for a FDG PET/CT examination to the nuclear medicine department of Brest University Hospital were consecutively enrolled, during a 3-month period. Cases presenting lung or liver uptakes were analyzed. Two sets of images were reconstructed from data recorded during a unique acquisition with a continuous table speed of 1 mm/s of the used Biograph mCT Flow PET/CT scanner: standard free-breathing images, and respiratory-gated images. Lesion location and quantitative parameters were recorded and compared. Results From October 1 2015 to December 31 2015, 847 patients were referred for FDG PET/CT, 741 underwent a respiratory-gated acquisition. Out of them, 213 (29%) had one or more lung or liver uptake but 82 (38%) had no usable respiratory-gated signal. Accordingly, 131 (62%) patients with 183 lung or liver uptakes were analyzed. Considering the 183 lesions, 140 and 43 were located in the lungs and the liver, respectively. The median (IQR) difference between respiratory-gated images and non-gated images was 18% (4−32) for SUVmax, increasing to 30% (14−57) in lower lobes for lung lesions, and −18% (−40 to −4) for MTV (p < 0.05). Technologists’ active personal dosimetry and mean total examinations duration were not statistically different between periods with and without respiratory gating. Conclusion This study showed that a systematic respiratory-gated acquisition without increasing acquisition time is feasible in a daily routine and results in a significant impact on PET quantification. However, clinical impact on patient management remains to be determined.
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Affiliation(s)
- Philippe Robin
- Service de Médecine Nucléaire, EA 3878 (GETBO) IFR 148, Centre Hospitalier Régional et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
| | - David Bourhis
- Service de Médecine Nucléaire, EA 3878 (GETBO) IFR 148, Centre Hospitalier Régional et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
| | - Brieuc Bernard
- Service de Médecine Nucléaire, EA 3878 (GETBO) IFR 148, Centre Hospitalier Régional et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
| | - Ronan Abgral
- Service de Médecine Nucléaire, EA 3878 (GETBO) IFR 148, Centre Hospitalier Régional et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
| | - Solène Querellou
- Service de Médecine Nucléaire, EA 3878 (GETBO) IFR 148, Centre Hospitalier Régional et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
| | - Alexandra Le Duc-Pennec
- Service de Médecine Nucléaire, EA 3878 (GETBO) IFR 148, Centre Hospitalier Régional et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
| | - Pierre-Yves Le Roux
- Service de Médecine Nucléaire, EA 3878 (GETBO) IFR 148, Centre Hospitalier Régional et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
| | - Pierre-Yves Salaün
- Service de Médecine Nucléaire, EA 3878 (GETBO) IFR 148, Centre Hospitalier Régional et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
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Abstract
BACKGROUND Neoadjuvant chemoradiotherapy followed by an optimal surgery is the standard treatment for patients with locally advanced rectal cancer. FDG-PET/CT is commonly used as the modality for assessing the effect of chemoradiotherapy. OBJECTIVE The purpose of this study was to investigate whether PET/CT-based volumetry could contribute to the prediction of pathological complete response or prognosis after neoadjuvant chemoradiotherapy. DESIGN This was a retrospective cohort study. SETTINGS This study was conducted at a single research center. PATIENTS Ninety-one consecutive patients with locally advanced rectal cancer were enrolled between January 2005 and December 2015. INTERVENTION Patients underwent PET/CT before and after neoadjuvant chemoradiotherapy. MAIN OUTCOME MEASURES Maximum standardized uptake value and total lesion glycolysis on PET/CT before and after neoadjuvant chemoradiotherapy were calculated using isocontour methods. Correlations between these variables and clinicopathological factors and prognosis were assessed. RESULTS PET/CT-associated variables before chemoradiotherapy were not correlated with either clinicopathological factors or prognosis. Maximum standardized uptake value was associated with pathological complete response, but total lesion glycolysis was not. Maximum standardized uptake value correlated with ypT, whereas total lesion glycolysis correlated with both ypT and ypN. High total lesion glycolysis was associated with a considerably poorer prognosis; the 5-year recurrence rate was 65% and the 5-year mortality rate 42%, whereas in lesions with low total lesion glycolysis, these were 6% and 2%. On multivariate analysis, high total lesion glycolysis was an independent risk factor for recurrence (HR = 4.718; p = 0.04). LIMITATIONS The gain in fluoro-2-deoxy-D-glucose uptake may differ between scanners, thus the general applicability of this threshold should be validated. CONCLUSIONS In patients with locally advanced rectal cancer, high total lesion glycolysis after neoadjuvant chemoradiotherapy is strongly associated with a worse prognosis. Total lesion glycolysis after chemoradiotherapy may be a promising preoperative predictor of recurrence and death. See Video Abstract at http://links.lww.com/DCR/A464.
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Metabolic Tumor Volume and Total Lesion Glycolysis in Oropharyngeal Cancer Treated With Definitive Radiotherapy: Which Threshold Is the Best Predictor of Local Control? Clin Nucl Med 2017; 42:e281-e285. [PMID: 28288042 DOI: 10.1097/rlu.0000000000001614] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE In the context of oropharyngeal cancer treated with definitive radiotherapy, the aim of this retrospective study was to identify the best threshold value to compute metabolic tumor volume (MTV) and/or total lesion glycolysis to predict local-regional control (LRC) and disease-free survival. METHODS One hundred twenty patients with a locally advanced oropharyngeal cancer from 2 different institutions treated with definitive radiotherapy underwent FDG PET/CT before treatment. Various MTVs and total lesion glycolysis were defined based on 2 segmentation methods: (i) an absolute threshold of SUV (0-20 g/mL) or (ii) a relative threshold for SUVmax (0%-100%). The parameters' predictive capabilities for disease-free survival and LRC were assessed using the Harrell C-index and Cox regression model. RESULTS Relative thresholds between 40% and 68% and absolute threshold between 5.5 and 7 had a similar predictive value for LRC (C-index = 0.65 and 0.64, respectively). Metabolic tumor volume had a higher predictive value than gross tumor volume (C-index = 0.61) and SUVmax (C-index = 0.54). Metabolic tumor volume computed with a relative threshold of 51% of SUVmax was the best predictor of disease-free survival (hazard ratio, 1.23 [per 10 mL], P = 0.009) and LRC (hazard ratio: 1.22 [per 10 mL], P = 0.02). CONCLUSIONS The use of different thresholds within a reasonable range (between 5.5 and 7 for an absolute threshold and between 40% and 68% for a relative threshold) seems to have no major impact on the predictive value of MTV. This parameter may be used to identify patient with a high risk of recurrence and who may benefit from treatment intensification.
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Lee I, Im HJ, Solaiyappan M, Cho SY. Comparison of novel multi-level Otsu (MO-PET) and conventional PET segmentation methods for measuring FDG metabolic tumor volume in patients with soft tissue sarcoma. EJNMMI Phys 2017; 4:22. [PMID: 28921170 PMCID: PMC5603470 DOI: 10.1186/s40658-017-0189-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 09/01/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We have previously developed a novel and highly consistent PET segmentation algorithm using a multi-level Otsu method (MO-PET). The aim of this study was to evaluate the reliability of MO-PET compared to conventional PET segmentation methods for measuring 18F-FDG (FDG) PET metabolic tumor volume (MTV) in patients with soft tissue sarcoma (STS). Clinical and imaging data were obtained from the Cancer Imaging Archive. Forty-eight STS patients with FDG PET/CT and MR prior to therapy were analyzed. MTV of the tumor using MO-PET was compared to other conventional methods (absolute SUV threshold values of 2.0, 2.5, or 3.0 and percentage of tumor SUVmax values of 30, 40, 50, or 60%) and gradient-based method (PET Edge™). The reference volume was defined as an MR-based gross tumor volume (GTV). Spearman, intra-class correlation, and Bland-Altman analysis were performed to evaluate the correlation and agreement of MTV to GTV. RESULTS MTVs obtained using each conventional SUV parameter, PET Edge™, and MO-PET were highly correlated with the GTV in Spearman and intra-class correlation analysis (p < 0.05). MO-PET and PET Edge™ showed high intra-class correlation coefficient of MTV to GTV (0.93 and 0.84, respectively). The Bland-Altman bias results showed the highest agreement for MTV using MO-PET with GTV (26.0 ± 489.6 cm3) compared to other methods (SUV 2.0 with - 69.3 ± 765.8, 30% SUVmax with - 255.0 ± 876.6, and PET Edge™ with - 26.46 ± 668.82 cm3). CONCLUSIONS PET MTV segmented with MO-PET showed higher correlation and agreement with GTV in comparison to conventional percentage SUVmax and absolute SUV threshold-based PET segmentation methods. MO-PET is comparable to PET Edge™. MO-PET is a reliable and consistent method for measuring tumor MTV.
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Affiliation(s)
- Inki Lee
- Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Hyung-Jun Im
- Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Steve Y Cho
- Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
- Radiology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
- University of Wisconsin Carbon Cancer Center, Madison, WI, USA.
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Sato J, Kitagawa Y, Watanabe S, Asaka T, Ohga N, Hirata K, Okamoto S, Shiga T, Shindoh M, Kuge Y, Tamaki N. 18 F-Fluoromisonidazole positron emission tomography (FMISO-PET) may reflect hypoxia and cell proliferation activity in oral squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:261-270. [DOI: 10.1016/j.oooo.2017.05.506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 05/13/2017] [Accepted: 05/16/2017] [Indexed: 12/15/2022]
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Tatcı E, Uslu Biner İ, Emir S, Tanyıldız HG, Özmen Ö, Alagöz E, Gökçek A, Şahin G. The Correlation Between Pre-treatment Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Parameters and Clinical Prognostic Factors in Pediatric Hodgkin Lymphoma. Mol Imaging Radionucl Ther 2017; 26:9-16. [PMID: 28291005 PMCID: PMC5350506 DOI: 10.4274/mirt.94914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective: To compare standardized uptake values (SUV) derived from pre-treatment 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging and clinical prognostic factors in pediatric patients with Hodgkin lymphoma (HL). Methods: Pre-treatment FDG PET/CT findings of 28 children with HL were evaluated in this retrospective study. Metabolic tumor volume (MTV), SUVmax normalized by weight (SUVweight), lean body mass (SUVlbm), body surface area (SUVbsa) and plasma glucose levels of tumors (SUVglucose) were calculated using pre-treatment FDG PET/CT scan images. These metabolic parameters were correlated with clinical factors [age, sex, number of lymph node groups, presence of splenic involvement, bulky mediastinal disease, Ann Arbor stage, serum white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), serum albumin and hemoglobin levels]. Results: SUVbsa, SUVlbm, SUVweight, SUVglucose and MTV were higher in patients with stage III-IV disease, bulky tumor and ≥3 lymph node groups (p<0.05). SUVbsa and SUVglucose were higher in patients with splenic involvement (p<0.05). There was no significant correlation between these metabolic parameters and sex, ESR, levels of albumin and WBC (p>0.05). SUVbsa and SUVlbm were higher in patients with anemia (p<0.05). Additionally, significant increases were detected in SUVweight, MTV, and SUVglucose with increasing age (p=0.005, p=0.027, and p=0.009, respectively). SUVbsa and SUVlbm had no significant correlation with age (p>0.05). Conclusion: Metabolic parameters derived from pre-treatment FDG PET/CT may have an important role in predicting high-risk disease in patients with HL. Also, SUVbsa and SUVlbm may be better markers than SUVweight in the quantitative evaluation of FDG PET/CT scans in pediatric patients.
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Affiliation(s)
- Ebru Tatcı
- Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Nuclear Medicine, Ankara, Turkey Phone: +90 505 914 53 61 E-mail:
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Hoshikawa H, Mori T, Maeda Y, Takahashi S, Ouchi Y, Yamamoto Y, Nishiyama Y. Influence of volumetric 4'-[methyl- 11C]-thiothymidine PET/CT parameters for prediction of the clinical outcome of head and neck cancer patients. Ann Nucl Med 2016; 31:63-70. [PMID: 27679399 DOI: 10.1007/s12149-016-1131-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 09/23/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This prospective study compared the value of pretreatment 4'-[methyl-11C]-thiothymidine (11C-4DST) volumetric parameters and those of 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG) in predicting the clinical outcome in patients with head and neck squamous cell carcinoma (HNSCC). METHODS Fifty patients with HNSCC underwent 11C-4DST PET/CT and 18F-FDG PET/CT prior to anticancer therapy. 18F-FDG metabolic tumor volume (18F-FDG MTV) and total lesion glycolysis (TLG) were calculated from 18F-FDG PET, and 11C-4DST MTV and total lesion proliferation (TLP) were calculated from 11C-4DST PET. All parameters were measured for the primary lesion and metastatic lymph nodes. Associations between clinical factors and PET/CT parameters and prognostic value were analyzed. RESULTS Receiver-operating characteristic analysis revealed that MTV, TLG, and TLP acquired from the primary lesion and metastatic lymph nodes were good parameters for predicting disease relapse and death. The area under the curves (AUCs) ranged from 0.63 to 0.71 for 18F-FDG PET/CT parameters. The AUCs of 11C-4DST PET/CT parameters were larger than those of 18F-FDG (range 0.72-0.81). Univariate analysis revealed that individuals with tumors showing a high value for any PET/CT parameter were at a significantly increased risk of relapse. Upon multivariate analysis, 18F-FDG MTV, 11C-4DST MTV and 11C-4DST TLP were significant independent factors for relapse-free survival (P = 0.04, P = 0.0001 and P = 0.0005, respectively). CONCLUSION Pretreatment 11C-4DST PET/CT volume-based parameters can provide important prognostic information about patients with HNSCC.
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Affiliation(s)
- Hiroshi Hoshikawa
- Department of Otolaryngology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan.
| | - Terushige Mori
- Department of Otolaryngology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan
| | - Yukito Maeda
- Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Satoshi Takahashi
- Department of Otolaryngology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan
| | - Yohei Ouchi
- Department of Otolaryngology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan
| | - Yuka Yamamoto
- Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yoshihiro Nishiyama
- Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Yabuki K, Sano D, Shiono O, Arai Y, Chiba Y, Tanabe T, Nishimura G, Takahashi M, Taguchi T, Kaneta T, Hata M, Oridate N. Surgery-based versus radiation-based treatment strategy for a high metabolic volume laryngeal cancer. Laryngoscope 2016; 127:862-867. [DOI: 10.1002/lary.26233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/12/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Kenichiro Yabuki
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Daisuke Sano
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Osamu Shiono
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Yasuhiro Arai
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Yoshihiro Chiba
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Teruhiko Tanabe
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Goshi Nishimura
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Masahiro Takahashi
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Takahide Taguchi
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Tomohiro Kaneta
- Department of Radiology; Yokohama City University School of Medicine; Yokohama Japan
| | - Masaharu Hata
- Department of Oncology; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Nobuhiko Oridate
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
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Cacicedo J, Navarro A, Del Hoyo O, Gomez-Iturriaga A, Alongi F, Medina JA, Elicin O, Skanjeti A, Giammarile F, Bilbao P, Casquero F, de Bari B, Dal Pra A. Role of fluorine-18 fluorodeoxyglucose PET/CT in head and neck oncology: the point of view of the radiation oncologist. Br J Radiol 2016; 89:20160217. [PMID: 27416996 DOI: 10.1259/bjr.20160217] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Squamous cell carcinoma is the most common malignant tumour of the head and neck. The initial TNM staging, the evaluation of the tumour response during treatment, and the long-term surveillance are crucial moments in the approach to head and neck squamous cell carcinoma (HNSCC). Thus, at each of these moments, the choice of the best diagnostic tool providing the more precise and larger information is crucial. Positron emission tomography with fluorine-18 fludeoxyglucose integrated with CT (18F-FDG-PET/CT) rapidly gained clinical acceptance, and it has become an important imaging tool in routine clinical oncology. However, controversial data are currently available, for example, on the role of 18F-FDG-PET/CT imaging during radiotherapy planning, the prognostic value or its real clinical impact on treatment decisions. In this article, the role of 18F-FDG-PET/CT imaging in HNSCC during pre-treatment staging, radiotherapy planning, treatment response assessment, prognosis and follow-up is reviewed focusing on current evidence and controversial issues. A proposal on how to integrate 18F-FDG-PET/CT in daily clinical practice is also described.
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Affiliation(s)
- Jon Cacicedo
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain.,2 Grupo Español de Oncología Radioterápica en Cabeza y Cuello (GEORCC)
| | - Arturo Navarro
- 3 Radiation Oncology Department, Hospital Duran i Reynals (ICO) Avda, Gran Via de L´Hospitalet, Hospitalet de Llobregat, Barcelona, Spain
| | - Olga Del Hoyo
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
| | - Alfonso Gomez-Iturriaga
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
| | - Filippo Alongi
- 4 Radiation Oncology Department, Sacro Cuore-Don Calabria Hospital, Verona, Italy
| | - Jose A Medina
- 2 Grupo Español de Oncología Radioterápica en Cabeza y Cuello (GEORCC).,5 Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Olgun Elicin
- 6 Radiation Oncology Department, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Andrea Skanjeti
- 7 Nuclear Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Francesco Giammarile
- 7 Nuclear Medicine Department, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Pedro Bilbao
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
| | - Francisco Casquero
- 1 Radiation Oncology Department, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
| | - Berardino de Bari
- 8 fESTRO Radiation Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Alan Dal Pra
- 6 Radiation Oncology Department, Inselspital, Bern University Hospital, Bern, Switzerland
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Min M, Lin P, Liney G, Lee M, Forstner D, Fowler A, Holloway L. A review of the predictive role of functional imaging in patients with mucosal primary head and neck cancer treated with radiation therapy. J Med Imaging Radiat Oncol 2016; 61:99-123. [DOI: 10.1111/1754-9485.12496] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 06/11/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Myo Min
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Ingham Institute of Applied Medical Research; Liverpool New South Wales Australia
| | - Peter Lin
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Department of Nuclear Medicine and Positron Emission Tomography; Liverpool Hospital; Liverpool New South Wales Australia
- University of Western Sydney; Sydney New South Wales Australia
| | - Gary Liney
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Ingham Institute of Applied Medical Research; Liverpool New South Wales Australia
- Centre for Medical Radiation Physics; University of Wollongong; Wollongong New South Wales Australia
| | - Mark Lee
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
| | - Dion Forstner
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Ingham Institute of Applied Medical Research; Liverpool New South Wales Australia
| | - Allan Fowler
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
| | - Lois Holloway
- Cancer Therapy Centre; Liverpool Hospital; Liverpool New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
- Ingham Institute of Applied Medical Research; Liverpool New South Wales Australia
- Centre for Medical Radiation Physics; University of Wollongong; Wollongong New South Wales Australia
- Institute of Medical Physics; School of Physics; University of Sydney; Sydney New South Wales Australia
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Pretreatment tumor SUVmax predicts disease-specific and overall survival in patients with head and neck soft tissue sarcoma. Eur J Nucl Med Mol Imaging 2016; 44:33-40. [DOI: 10.1007/s00259-016-3456-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/01/2016] [Indexed: 12/16/2022]
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Suzuki H, Nishio M, Nakanishi H, Hanai N, Hirakawa H, Kodaira T, Tamaki T, Hasegawa Y. Impact of total lesion glycolysis measured by 18F-FDG-PET/CT on overall survival and distant metastasis in hypopharyngeal cancer. Oncol Lett 2016; 12:1493-1500. [PMID: 27446459 DOI: 10.3892/ol.2016.4765] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 05/06/2016] [Indexed: 11/05/2022] Open
Abstract
The present study investigated the possible correlation between 18F-2-fluorodeoxyglucose (18F-FDG)-uptake parameters and clinicopathological parameters in hypopharyngeal squamous cell carcinoma (HPSCC). A total of 53 patients, newly diagnosed with HPSCC, received pretreatment 18F-FDG-positron emission tomography/computed tomography (PET/CT). Metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum and peak standardized uptake values (SUVmax and SUVpeak) were calculated as 18F-FDG-uptake parameters of the primary tumor. Tumor thickness, depth of invasion and pathological tumor volume were pathologically measured. Upon univariate survival analysis, SUVmax ≥28.5, SUVpeak ≥19, MTV ≥12 and TLG ≥42 were significantly associated with a shorter overall survival (OS) time, and MTV ≥12 and TLG ≥42 were significantly associated with a shorter distant metastasis-free survival (DMFS) time. Upon multivariate analysis with adjustment for clinical T category and treatment group, patients with SUVmax ≥28.5 exhibited a significantly shorter OS time, while TLG ≥42 was significantly correlated with shorter OS and DMFS times. Upon simple regression analysis, TLG was found to be significantly associated with tumor thickness and depth of invasion, while MTV was found to be closely associated with pathological tumor volume. In conclusion, pretreatment 18F-FDG-PET/CT is likely to provide valuable prognostic parameters in HPSCC.
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Affiliation(s)
- Hidenori Suzuki
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Masami Nishio
- Department of Radiology, Nagoya Positron Emission Tomography Imaging Center, Nagoya, Aichi 454-0933, Japan
| | - Hayao Nakanishi
- Department of Pathology, Aichi Cancer Center Aichi Hospital, Okazaki, Aichi 444-0011, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Hitoshi Hirakawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Tsuneo Tamaki
- Department of Radiology, East Nagoya Positron Emission Tomography Imaging Center, Nagoya, Aichi 464-0044, Japan
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
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Is There a Role for PET/CT Parameters to Characterize Benign, Malignant, and Metastatic Parotid Tumors? AJR Am J Roentgenol 2016; 207:635-40. [PMID: 27276388 DOI: 10.2214/ajr.15.15590] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Assessment of benign and malignant lesions of the parotid gland, including metastatic lesions, is challenging with current imaging methods. Fluorine-18 FDG PET/CT is a noninvasive imaging modality that provides both anatomic and metabolic information. Semiquantitative data obtained from PET/CT, also known as PET/CT parameters, are maximum, mean, or peak standardized uptake values (SUVs); metabolic tumor volume; total lesion glycolysis; standardized added metabolic activity; and normalized standardized added metabolic activity. Our aim was to determine whether FDG PET/CT parameters can differentiate benign, malignant, and metastatic parotid tumors. MATERIALS AND METHODS Thirty-four patients with parotid neoplasms underwent PET/CT before parotidectomy; maximum SUV, mean SUV, peak SUV, total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity were calculated on a dedicated workstation. Univariate analyses were performed. A ROC analysis was used to determine the ability of PET/CT parameters to predict pathologically proven benign, malignant, and metastatic parotid gland neoplasms. RESULTS Fourteen patients had a benign or malignant primary parotid tumor. Twenty had metastases to the parotid gland. When the specificity was set to at least 85% for each parameter to identify cut points, the corresponding sensitivities ranged from 15% to 40%. Assessment of benign versus malignant lesions of parotid tumors, as well as metastasis from squamous cell carcinoma versus other metastatic causes, revealed that none of the PET/CT parameters has enough power to differentiate among these groups. CONCLUSION PET/CT parameters, including total lesion glycolysis, metabolic tumor volume, standardized added metabolic activity, and normalized standardized added metabolic activity, are not able to differentiate benign from malignant parotid tumors, primary parotid tumors from metastasis, or metastasis from squamous cell carcinoma and nonsquamous cell carcinoma metastasis.
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Yabuki K, Sano D, Shiono O, Arai Y, Takahashi H, Chiba Y, Tanabe T, Nishimura G, Takahashi M, Taguchi T, Kaneta T, Hata M, Oridate N. Prognostic significance of metabolic tumor volume in patients with piriform sinus carcinoma treated by radiotherapy with or without concurrent chemotherapy. Head Neck 2016; 38:1666-1671. [DOI: 10.1002/hed.24488] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 02/27/2016] [Accepted: 03/17/2016] [Indexed: 11/08/2022] Open
Affiliation(s)
- Kenichiro Yabuki
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Daisuke Sano
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Osamu Shiono
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Yasuhiro Arai
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Hideaki Takahashi
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Yoshihiro Chiba
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Teruhiko Tanabe
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Goshi Nishimura
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Masahiro Takahashi
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Takahide Taguchi
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
| | - Tomohiro Kaneta
- Department of Radiology; Yokohama City University School of Medicine; Yokohama Japan
| | - Masaharu Hata
- Department of Oncology; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Nobuhiko Oridate
- Department of Otorhinolaryngology, Head and Neck Surgery; Yokohama City University School of Medicine; Yokohama Japan
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Kang CM, Lee SH, Hwang HK, Yun M, Lee WJ. Preoperative Volume-Based PET Parameter, MTV2.5, as a Potential Surrogate Marker for Tumor Biology and Recurrence in Resected Pancreatic Cancer. Medicine (Baltimore) 2016; 95:e2595. [PMID: 26945350 PMCID: PMC4782834 DOI: 10.1097/md.0000000000002595] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
This study aims to evaluate the role of volume-based positron emission tomography parameters as potential surrogate markers for tumor recurrence in resected pancreatic cancer. Between January 2008 and October 2012, medical records of patients who underwent surgical resection for pancreatic ductal adenocarcinoma and completed ¹⁸F-fluorodeoxyglucose positron emission tomography/CT as a part of preoperative staging work-up were retrospectively reviewed. Not only clinicopathologic variables but also positron emission tomography parameters such as SUVmax, MTV2.5 (metabolic tumor volume), and TLG (total lesion glycolysis) were obtained. Twenty-six patients were women and 31 were men with a mean age of 62.9 ± 9.1 years. All patients were preoperatively determined to resectable pancreatic cancer except 1 case with borderline resectability. R0 resection was achieved in all patients and 45 patients (78.9%) received postoperative adjuvant chemotherapy with or without radiation therapy. Median overall disease-free survival was 12.8 months with a median overall disease-specific survival of 25.1 months. SUVmax did not correlate with radiologic tumor size (P = 0.501); however, MTV2.5 (P = 0.001) and TLG (P = 0.009) were significantly associated with radiologic tumor size. In addition, MTV2.5 (P < 0.001) and TLG (P < 0.001) were significantly correlated with a tumor differentiation. There were no significant differences in TLG and SUVmax according to lymph node ratio; only MTV2.5 was related to lymph node ratio with marginal significance (P = 0.055). In multivariate analysis, lymph node ratio (Exp [β] = 2.425, P = 0.025) and MTV2.5 (Exp[β] = 2.273, P = 0.034) were identified as independent predictors of tumor recurrence following margin-negative resection. Even after tumor size-matched analysis, MTV2.5 was still identified as significant prognostic factor in resected pancreatic cancer (P < 0.05). However, preoperative neoadjuvant treatment attenuated adverse oncologic impact of high preoperative MTV2.5 (P = 0.210). Preoperatively determined volume-based PET parameter, MTV2.5, can potentially be used as a surrogate marker to estimate tumor biology and tumor recurrence. Individual treatment strategies for pancreatic cancer can be suggested based on patients' preoperative MTV2.5.
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Affiliation(s)
- Chang Moo Kang
- From the Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery (CMK, SHL, HKH, WJL); Nuclear Medicine (MY), Yonsei University College of Medicine; and Pancreaticobiliary Cancer Clinic (CMK, SHL, HKH, MY, WJL), Institute of Gastroenterology, Severance Hospital, Seoul, Korea
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