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Subramaniam RM. Quarter Century Positron Emission Tomography/Computed Tomography Transformation of Oncology: Head and Neck Cancer. PET Clin 2024; 19:125-129. [PMID: 38290968 DOI: 10.1016/j.cpet.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
During the last 2 decades, f-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F FDG PET/CT) has transformed the clinical head and neck cancer imaging for patient management and predicting survival outcomes. It is now widely used for staging, radiotherapy planning, posttherapy assessment, and for detecting recurrence in head and neck cancers and is widely included in NCCN and other evidence based clinical practice guidelines. Future Directions would include evaluating the potential value of FAPI PET/CT for head and neck cancers, opportunity to use volumetric and tumor heterogeneity parameters and deploying AI in diagnostic and therapeutic assessments.
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Affiliation(s)
- Rathan M Subramaniam
- Faculty of Medicine, Nursing & Midwifery and Health Sciences, University of Notre Dame Australia, Sydney, Australia; Department of Radiology, Duke University, Durham, NC, USA; Department of Medicine, University of Otago Medical School, Dunedin, New Zealand.
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Fujimoto K, Shiinoki T, Kawazoe Y, Yuasa Y, Mukaidani W, Manabe Y, Kajima M, Tanaka H. Biomechanical imaging biomarker during chemoradiotherapy predicts treatment response in head and neck squamous cell carcinoma. Phys Med Biol 2024; 69:055033. [PMID: 38359451 DOI: 10.1088/1361-6560/ad29b9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 02/15/2024] [Indexed: 02/17/2024]
Abstract
Objective. For response-adapted adaptive radiotherapy (R-ART), promising biomarkers are needed to predict post-radiotherapy (post-RT) responses using routine clinical information obtained during RT. In this study, a patient-specific biomechanical model (BM) of the head and neck squamous cell carcinoma (HNSCC) was proposed using the pre-RT maximum standardized uptake value (SUVmax) of18F-fluorodeoxyglucose (FDG) and tumor structural changes during RT as evaluated using computed tomography (CT). In addition, we evaluated the predictive performance of BM-driven imaging biomarkers for the treatment response of patients with HNSCC who underwent concurrent chemoradiotherapy (CCRT).Approach. Patients with histologically confirmed HNSCC treated with definitive CCRT were enrolled in this study. All patients underwent CT two times as follows: before the start of RT (pre-RT) and 3 weeks after the start of RT (mid-RT). Among these patients, 67 patients who underwent positron emission tomography/CT during the pre-RT period were included in the final analysis. The locoregional control (LC), progression-free survival (PFS), and overall survival (OS) prediction performances of whole tumor stress change (TS) between pre- and mid-RT computed using BM were assessed using univariate, multivariate, and Kaplan-Meier survival curve analyses, respectively. Furthermore, performance was compared with the pre and post-RT SUVmax, tumor volume reduction rate (TVRR) during RT, and other clinical prognostic factors.Main results. For both univariate, multivariate, and survival curve analyses, the significant prognostic factors were as follows (p< 0.05): TS and TVRR for LC; TS and pre-RT FDG-SUVmaxfor PFS; and TS only for OS. In addition, for 2 year LC, PFS, and OS prediction, TS showed a comparable predictive performance to post-RT FDG-SUVmax.Significance. BM-driven TS is an effective prognostic factor for tumor treatment response after CCRT. The proposed method can be a feasible functional imaging biomarker that can be acquired during RT using only routine clinical data and may provide useful information for decision-making during R-ART.
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Affiliation(s)
- Koya Fujimoto
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Takehiro Shiinoki
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Yusuke Kawazoe
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
- Department of Radiological Technology, Yamaguchi University Hospital, Ube, Japan
| | - Yuki Yuasa
- Department of Radiological Technology, Yamaguchi University Hospital, Ube, Japan
| | - Wataru Mukaidani
- Department of Radiological Technology, Yamaguchi University Hospital, Ube, Japan
| | - Yuki Manabe
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Miki Kajima
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
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Yamakawa N, Nakayama Y, Ueda N, Yagyuu T, Tamaki S, Kirita T. Volume-based 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters correlate with delayed neck metastasis in clinical early-stage oral squamous cell carcinoma. Oral Radiol 2023; 39:668-682. [PMID: 37081306 DOI: 10.1007/s11282-023-00686-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 04/11/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVE There is no known preoperative marker that can effectively predict the risk of delayed neck metastasis (DNM), which is an important factor that determines the prognosis of early-stage oral cancer. In this study, we examined whether 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET)/computed tomography (CT) uptake parameters of primary cancer can predict the risk of DNM in early-stage oral squamous cell carcinoma (OSCC). METHODS Data from patients with stage I-II OSCC who underwent surgical resection of the primary tumor without elective neck dissection between January 2009 and December 2016 were retrospectively reviewed. Patient characteristics, histopathological factors, and PET/CT parameters (maximum standardized uptake value [SUVmax], metabolic tumor volume [MTV], and total lesion glycolysis [TLG]) were evaluated for their association with DNM. DNM rates were calculated, and the parameters that were statistically significant in the univariate analysis were used as explanatory variables. Independent factors associated with DNM were identified using multivariate analysis. For all statistical analyses, p-values < 0.05 were considered statistically significant. RESULTS Data from 71 patients were analyzed in the study. The overall DNM rate among all patients was 21.8%. The univariate analysis showed that the T classification, depth of invasion, pattern of invasion, lymphovascular invasion, SUVmax, MTV, and TLG were significant predictors of DNM. However, the multivariate analysis revealed that only the depth of invasion, MTV, and TLG were independent predictors of DNM. CONCLUSION This study suggests that, in addition to conventional predictors, volume-based PET parameters are useful predictors of DNM in those with early-stage OSCC.
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Affiliation(s)
- Nobuhiro Yamakawa
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan.
| | - Yohei Nakayama
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Nobuhiro Ueda
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Takahiro Yagyuu
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Shigehiro Tamaki
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan
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Akay S, Pollard JH, Saad Eddin A, Alatoum A, Kandemirli S, Gholamrezanezhad A, Menda Y, Graham MM, Shariftabrizi A. PET/CT Imaging in Treatment Planning and Surveillance of Sinonasal Neoplasms. Cancers (Basel) 2023; 15:3759. [PMID: 37568575 PMCID: PMC10417627 DOI: 10.3390/cancers15153759] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Sinonasal cancers are uncommon malignancies with a generally unfavorable prognosis, often presenting at an advanced stage. Their high rate of recurrence supports close imaging surveillance and the utilization of functional imaging techniques. Whole-body 18F-FDG PET/CT has very high sensitivity for the diagnosis of sinonasal malignancies and can also be used as a "metabolic biopsy" in the characterization of some of the more common subgroups of these tumors, though due to overlap in uptake, histological confirmation is still needed. For certain tumor types, radiotracers, such as 11C-choline, and radiolabeled somatostatin analogs, including 68Ga-DOTATATE/DOTATOC, have proven useful in treatment planning and surveillance. Although serial scans for posttreatment surveillance allow the detection of subclinical lesions, the optimal schedule and efficacy in terms of survival are yet to be determined. Pitfalls of 18F-FDG, such as post-surgical and post-radiotherapy crusting and inflammation, may cause false-positive hypermetabolism in the absence of relapse.
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Affiliation(s)
- Sinan Akay
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Janet H. Pollard
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Assim Saad Eddin
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Aiah Alatoum
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Sedat Kandemirli
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90030, USA
| | - Yusuf Menda
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Michael M. Graham
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Ahmad Shariftabrizi
- Division of Nuclear Medicine, Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
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Holgado A, León X, Quer M, Camacho V, Fernández A. Association between maximum standarised uptake value (SUV) and local control in patients with oropharyngeal carcinoma treated with radiotherapy. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2023; 74:211-218. [PMID: 37149130 DOI: 10.1016/j.otoeng.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/19/2022] [Indexed: 05/08/2023]
Abstract
OBJECTIVE To analyse the prognostic ability of the maximum standardised uptake value (SUVmax) on local disease control in patients with oropharyngeal carcinoma treated with radiotherapy. MATERIAL AND METHODS Retrospective study of 105 patients with oropharyngeal carcinomas treated with radiotherapy, including chemo- and bio-radiotherapy, and who had a PET-CT scan prior to the start of treatment. RESULT Patients with a SUVmax value higher than 17.2 at the primary tumour site had a significantly higher risk of local recurrence. The 5-year local recurrence-free survival for patients with SUVmax less than or equal to 17.2 (n = 71) was 86.5% (95% CI 78.2-94.7 %), and for patients with SUVmax greater than 17.2 (n = 34) it was 55.8% (95% CI 36.0-75.6 %) (P = 0.0001). This difference in local control was maintained regardless of patients' HPV status. Specific survival was similarly lower for patients with a SUV greater than 17.2. The 5-year specific survival for patients with SUVmax greater than 17.2 was 39.5% (95% CI: 20.6-58.3 %), significantly shorter than that of patients with SUVmax equal to or less than 17.2, which was 77.3% (95% CI: 66.9-87.6 %) (P = 0.0001). CONCLUSIONS Patients with oropharyngeal carcinomas treated with radiotherapy with a SUVmax greater than 17.2 at the level of the primary tumour site had a significantly higher risk of local recurrence.
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Affiliation(s)
- Anna Holgado
- Servicio de Otorrinolaringología-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier León
- Servicio de Otorrinolaringología-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain; UVIC-->, Universitat Central de Catalunya, Vic, Spain.
| | - Miquel Quer
- Servicio de Otorrinolaringología-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Valle Camacho
- Servicio de Medicina Nuclear-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alejando Fernández
- Servicio de Medicina Nuclear-->, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Elahmadawy MA, Ashraf A, Moustafa H, Kotb M, Abd El-Gaid S. Prognostic value of initial [ 18 F]FDG PET/computed tomography volumetric and texture analysis-based parameters in patients with head and neck squamous cell carcinoma. Nucl Med Commun 2023; 44:653-662. [PMID: 37038954 DOI: 10.1097/mnm.0000000000001695] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
AIM OF WORK To determine the predictive value of initial [ 18 F]FDG PET/computed tomography (CT) volumetric and radiomics-derived analyses in patients with head and neck squamous cell carcinoma (HNSCC). METHODS Forty-six adult patients had pathologically proven HNSCC and underwent pretherapy [ 18 F]FDG PET/CT were enrolled. Semi-quantitative PET-derived volumetric [(maximum standardized uptake value (SUVmax) and mean SUV (SUVmean), total lesion glycolysis (TLG) and metabolic tumor volume (MTV)] and radiomics analyses using LIFEx 6.73.3 software were performed. RESULTS In the current study group, the receiver operating characteristic curve marked a cutoff point of 21.105 for primary MTV with area under the curve (AUC) of 0.727, sensitivity of 62.5%, and specificity of 86.8% ( P value 0.041) to distinguish responders from non-responders, while no statistically significant primary SUVmean or max or primary TLG cut off points could be determined. It also marked the cutoff point for survival prediction of 10.845 for primary MTV with AUC 0.728, sensitivity of 80%, and specificity of 77.8% ( P value 0.026). A test of the synergistic performance of PET-derived volumetric and textural features significant parameters was conducted in an attempt to develop the most accurate and stable prediction model. Therefore, multivariate logistic regression analysis was performed to detect independent predictors of mortality. With a high specificity of 97.1% and an overall accuracy of 89.1%, the combination of primary tumor MTV and the textural feature gray-level co-occurrence matrix correlation provided the most accurate prediction of mortality ( P value < 0.001). CONCLUSION Textural feature indices are a noninvasive method for capturing intra-tumoral heterogeneity. In our study, a PET-derived prediction model was successfully generated with high specificity and accuracy.
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Affiliation(s)
| | - Aya Ashraf
- Nuclear Medicine Unit, National Cancer Institute
| | - Hosna Moustafa
- Nuclear Medicine Unit, Kasr Al-Ainy (NEMROCK Center), Cairo University, Cairo, Egypt
| | - Magdy Kotb
- Nuclear Medicine Unit, National Cancer Institute
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Šedienė S, Kulakienė I, Urbonavičius BG, Korobeinikova E, Rudžianskas V, Povilonis PA, Jaselskė E, Adlienė D, Juozaitytė E. Development of a Model Based on Delta-Radiomic Features for the Optimization of Head and Neck Squamous Cell Carcinoma Patient Treatment. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1173. [PMID: 37374377 DOI: 10.3390/medicina59061173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/25/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: To our knowledge, this is the first study that investigated the prognostic value of radiomics features extracted from not only staging 18F-fluorodeoxyglucose positron emission tomography (FDG PET/CT) images, but also post-induction chemotherapy (ICT) PET/CT images. This study aimed to construct a training model based on radiomics features obtained from PET/CT in a cohort of patients with locally advanced head and neck squamous cell carcinoma treated with ICT, to predict locoregional recurrence, development of distant metastases, and the overall survival, and to extract the most significant radiomics features, which were included in the final model. Materials and Methods: This retrospective study analyzed data of 55 patients. All patients underwent PET/CT at the initial staging and after ICT. Along the classical set of 13 parameters, the original 52 parameters were extracted from each PET/CT study and an additional 52 parameters were generated as a difference between radiomics parameters before and after the ICT. Five machine learning algorithms were tested. Results: The Random Forest algorithm demonstrated the best performance (R2 0.963-0.998) in the majority of datasets. The strongest correlation in the classical dataset was between the time to disease progression and time to death (r = 0.89). Another strong correlation (r ≥ 0.8) was between higher-order texture indices GLRLM_GLNU, GLRLM_SZLGE, and GLRLM_ZLNU and standard PET parameters MTV, TLG, and SUVmax. Patients with a higher numerical expression of GLCM_ContrastVariance, extracted from the delta dataset, had a longer survival and longer time until progression (p = 0.001). Good correlations were observed between Discretized_SUVstd or Discretized_SUVSkewness and time until progression (p = 0.007). Conclusions: Radiomics features extracted from the delta dataset produced the most robust data. Most of the parameters had a positive impact on the prediction of the overall survival and the time until progression. The strongest single parameter was GLCM_ContrastVariance. Discretized_SUVstd or Discretized_SUVSkewness demonstrated a strong correlation with the time until progression.
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Affiliation(s)
- Severina Šedienė
- Department of Radiology of Lithuanian, University of Health Sciences, Eivenių g. 2, LT-50161 Kaunas, Lithuania
| | - Ilona Kulakienė
- Department of Radiology of Lithuanian, University of Health Sciences, Eivenių g. 2, LT-50161 Kaunas, Lithuania
| | - Benas Gabrielis Urbonavičius
- Department of Physics, Faculty of Mathematics and Natural Sciences, Kaunas University of Technology, Studentu g. 50, LT-51368 Kaunas, Lithuania
| | - Erika Korobeinikova
- Oncology Institute of Lithuanian, University of Health Sciences, Eiveniu g. 2, LT-50161 Kaunas, Lithuania
| | - Viktoras Rudžianskas
- Oncology Institute of Lithuanian, University of Health Sciences, Eiveniu g. 2, LT-50161 Kaunas, Lithuania
| | - Paulius Algirdas Povilonis
- Medical Academy of Lithuania, University of Health Sciences, A. Mickeviciaus g. 9, LT-44307 Kaunas, Lithuania
| | - Evelina Jaselskė
- Department of Physics, Faculty of Mathematics and Natural Sciences, Kaunas University of Technology, Studentu g. 50, LT-51368 Kaunas, Lithuania
| | - Diana Adlienė
- Department of Physics, Faculty of Mathematics and Natural Sciences, Kaunas University of Technology, Studentu g. 50, LT-51368 Kaunas, Lithuania
| | - Elona Juozaitytė
- Oncology Institute of Lithuanian, University of Health Sciences, Eiveniu g. 2, LT-50161 Kaunas, Lithuania
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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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Agüloğlu N, Aksu A, Unat DS, Akyol M. The prognostic relationship of 18F-FDG PET/CT metabolic and volumetric parameters in metastatic ALK + NSCLC. Nucl Med Commun 2022; 43:1217-1224. [PMID: 36345766 DOI: 10.1097/mnm.0000000000001625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The aim of this study is to determine the role of metabolic and volumetric parameters obtained from 18Fluorine-Fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) imaging on progression-free survival (PFS) and overall survival (OS) in patients with advanced nonsquamous cell lung carcinoma (NSCLC) with anaplastic lymphoma kinase (ALK) rearrangement. METHODS Pre and post-treatment PET/CT images of the ALK + NSCLC patients between January 2015 and July 2020 were evaluated. The highest standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values were obtained from pre-tyrosine kinase inhibitor (TKI) basal PET/CT (PETpre) and post-TKI PET/CT (PETpost) images. Total MTV (tMTV) and total TLG (tTLG) values were calculated by summing MTV and TLG values in all tumor foci. The change (Δ) in pSUVmax, pMTV, pTLG, tMTV and tTLG before and after treatment was calculated.The relationship of these parameters with OS and PFS was analyzed. RESULTS tTLGpre, tMTVpre, pTLGpre, pMTVpre, ∆SUVmax, ∆tMTV and ∆tTLG values were found to be associated with OS; ∆tMTV, ∆tTLG, tTLGpre, tMTVpre, pTLGpre and pMTVpre were associated with PFS. The cutoff values in both predicting OS and PFS were calculated as -31.6 and 391.1 for ∆tMTV and tTLGpre, respectively. In Cox regression analysis, ∆tMTV and stage for OS and ∆tMTV and tTLGpre for PFS were obtained as prognostic factors. CONCLUSIONS Metabolic and volumetric parameters, especially TLG values in the whole body before treatment and change in whole body MTV value, obtained from PET/CT may be useful in predicting prognosis and determining treatment strategies for patients with advanced ALK + NSCLC.
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Affiliation(s)
- Nurşin Agüloğlu
- Department of Nuclear Medicine, Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, İzmir
| | - Ayşegül Aksu
- Department of Nuclear Medicine, Başakşehir Çam and Sakura City Hospital, İstanbul
| | - Damla S Unat
- Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital İzmir, Turkey
| | - Murat Akyol
- Department of Medical Oncology, Bakirçay University Medical School İzmir, Turkey
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Asociación entre el standarized uptake value (SUV) máximo y el control local en pacientes con carcinoma de orofaringe tratados con radioterapia. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022. [DOI: 10.1016/j.otorri.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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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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Wahid KA, He R, Dede C, Mohamed ASR, Abdelaal MA, van Dijk LV, Fuller CD, Naser MA. Combining Tumor Segmentation Masks with PET/CT Images and Clinical Data in a Deep Learning Framework for Improved Prognostic Prediction in Head and Neck Squamous Cell Carcinoma. HEAD AND NECK TUMOR SEGMENTATION AND OUTCOME PREDICTION : SECOND CHALLENGE, HECKTOR 2021, HELD IN CONJUNCTION WITH MICCAI 2021, STRASBOURG, FRANCE, SEPTEMBER 27, 2021, PROCEEDINGS. HEAD AND NECK TUMOR SEGMENTATION CHALLENGE (2ND : 2021 ... 2022; 13209:300-307. [PMID: 35399870 PMCID: PMC8991448 DOI: 10.1007/978-3-030-98253-9_28] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PET/CT images provide a rich data source for clinical prediction models in head and neck squamous cell carcinoma (HNSCC). Deep learning models often use images in an end-to-end fashion with clinical data or no additional input for predictions. However, in the context of HNSCC, the tumor region of interest may be an informative prior in the generation of improved prediction performance. In this study, we utilize a deep learning framework based on a DenseNet architecture to combine PET images, CT images, primary tumor segmentation masks, and clinical data as separate channels to predict progression-free survival (PFS) in days for HNSCC patients. Through internal validation (10-fold cross-validation) based on a large set of training data provided by the 2021 HECKTOR Challenge, we achieve a mean C-index of 0.855 ± 0.060 and 0.650 ± 0.074 when observed events are and are not included in the C-index calculation, respectively. Ensemble approaches applied to cross-validation folds yield C-index values up to 0.698 in the independent test set (external validation), leading to a 1st place ranking on the competition leaderboard. Importantly, the value of the added segmentation mask is underscored in both internal and external validation by an improvement of the C-index when compared to models that do not utilize the segmentation mask. These promising results highlight the utility of including segmentation masks as additional input channels in deep learning pipelines for clinical outcome prediction in HNSCC.
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Affiliation(s)
- Kareem A Wahid
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston, TX 77030, USA
| | - Renjie He
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston, TX 77030, USA
| | - Cem Dede
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston, TX 77030, USA
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston, TX 77030, USA
| | - Moamen Abobakr Abdelaal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston, TX 77030, USA
| | - Lisanne V van Dijk
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston, TX 77030, USA
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston, TX 77030, USA
| | - Mohamed A Naser
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer, Houston, TX 77030, USA
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Cegla P, Currie G, Wróblewska JP, Cholewiński W, Kaźmierska J, Marszałek A, Kubiak A, Golusinski P, Golusiński W, Majchrzak E. Influence of Semiquantitative [18F]FDG PET and Hematological Parameters on Survival in HNSCC Patients Using Neural Network Analysis. Pharmaceuticals (Basel) 2022; 15:ph15020224. [PMID: 35215335 PMCID: PMC8875232 DOI: 10.3390/ph15020224] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 02/08/2023] Open
Abstract
The aim of this study is to assess the influence of semiquantitative PET-derived parameters as well as hematological parameters in overall survival in HNSCC patients using neural network analysis. Retrospective analysis was performed on 106 previously untreated HNSCC patients. Several PET-derived parameters (SUVmax, SUVmean, TotalSUV, MTV, TLG, TLRmax, TLRmean, TLRTLG, and HI) for primary tumor and lymph node with highest activity were assessed. Additionally, hematological parameters (LEU, LEU%, NEU, NEU%, MON, MON%, PLT, PLT%, NRL, and LMR) were also assessed. Patients were divided according to the diagnosis into the good and bad group. The data were evaluated using an artificial neural network (Neural Analyzer version 2.9.5) and conventional statistic. Statistically significant differences in PET-derived parameters in 5-year survival rate between group of patients with worse prognosis and good prognosis were shown in primary tumor SUVmax (10.0 vs. 7.7; p = 0.040), SUVmean (5.4 vs. 4.4; p = 0.047), MTV (23.2 vs. 14.5; p = 0.010), and TLG (155.0 vs. 87.5; p = 0.05), and mean liver TLG (27.8 vs. 30.4; p = 0.031), TLRmax (3.8 vs. 2.6; p = 0.019), TLRmean (2.8 vs. 1.9; p = 0.018), and in TLRTLG (5.6 vs. 2.3; p = 0.042). From hematological parameters, only LMR showed significant differences (2.5 vs. 3.2; p = 0.009). Final neural network showed that for ages above 60, primary tumors SUVmax, TotalSUV, MTV, TLG, TLRmax, and TLRmean over (9.7, 2255, 20.6, 145, 3.6, 2.6, respectively) are associated with worse survival. Our study shows that the neural network could serve as a supplement to PET-derived parameters and is helpful in finding prognostic parameters for overall survival in HNSCC.
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Affiliation(s)
- Paulina Cegla
- Department of Nuclear Medicine, Greater Poland Cancer Center, 61-866 Poznan, Poland;
- Correspondence:
| | - Geoffrey Currie
- School of Dentistry and Health Science, Charles Sturt University, Wagga Wagga 2678, Australia;
| | - Joanna P. Wróblewska
- Department of Oncologic Pathology and Prophylaxis, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (J.P.W.); (A.M.)
- Department of Tumor Pathology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Witold Cholewiński
- Department of Nuclear Medicine, Greater Poland Cancer Center, 61-866 Poznan, Poland;
- Department of Electroradiology, Poznan University of Medical Science, 61-701 Poznan, Poland;
| | - Joanna Kaźmierska
- Department of Electroradiology, Poznan University of Medical Science, 61-701 Poznan, Poland;
- 2nd Radiotherapy Department, Greater Poland Cancer Center, 61-866 Poznan, Poland
| | - Andrzej Marszałek
- Department of Oncologic Pathology and Prophylaxis, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (J.P.W.); (A.M.)
- Department of Tumor Pathology, Greater Poland Cancer Centre, 61-866 Poznan, Poland
| | - Anna Kubiak
- Greater Poland Cancer Registry, Greater Poland Cancer Centre, 61-866 Poznan, Poland;
| | - Pawel Golusinski
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, 65-046 Zielona Góra, Poland;
| | - Wojciech Golusiński
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Center, 61-866 Poznan, Poland; (W.G.); (E.M.)
| | - Ewa Majchrzak
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Center, 61-866 Poznan, Poland; (W.G.); (E.M.)
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den bossche VV, Zaryouh H, Vara-Messler M, Vignau J, Machiels JP, Wouters A, Schmitz S, Corbet C. Microenvironment-driven intratumoral heterogeneity in head and neck cancers: clinical challenges and opportunities for precision medicine. Drug Resist Updat 2022; 60:100806. [DOI: 10.1016/j.drup.2022.100806] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 02/06/2023]
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15
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Bos-Liedke A, Cegla P, Matuszewski K, Konstanty E, Piotrowski A, Gross M, Malicki J, Kozak M. Differences among [ 18F]FDG PET-derived parameters in lung cancer produced by three software packages. Sci Rep 2021; 11:13942. [PMID: 34230642 PMCID: PMC8260625 DOI: 10.1038/s41598-021-93436-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/18/2021] [Indexed: 02/06/2023] Open
Abstract
Investigation of differences in derived [18F]FDG PET metabolic and volumetric parameters among three different software programs in lung cancer. A retrospective analysis was performed on a group of 98 lung cancer patients who underwent a baseline [18F]FDG PET/CT study. To assess appropriate delineation methods, the NEMA phantom study was first performed using the following software: Philips EBW (Extended Brilliance Workstation), MIM Software and Rover. Based on this study, the best cut-off methods (dependent on tumour size) were selected, extracted and applied for lung cancer delineation. Several semiquantitative [18F]FDG parameters (SUVmax, SUVmean, TLG and MTV) were assessed and compared among the three software programs. The parameters were assessed based on body weight (BW), lean body mass (LBM) and Bq/mL. Statistically significant differences were found in SUVmean (LBM) between MIM Software and Rover (4.62 ± 2.15 vs 4.84 ± 1.20; p < 0.005), in SUVmean (Bq/mL) between Rover and Philips EBW (21,852.30 ± 21,821.23 vs 19,274.81 ± 13,340.28; p < 0.005) and Rover and MIM Software (21,852.30 ± 21,821.23 vs 19,399.40 ± 10,051.30; p < 0.005), and in MTV between MIM Software and Philips EBW (19.87 ± 25.83 vs 78.82 ± 228.00; p = 0.0489). This study showed statistically significant differences in the estimation of semiquantitative parameters using three independent image analysis tools. These findings are important for performing further diagnostic and treatment procedures in lung cancer patients.
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Affiliation(s)
- Agnieszka Bos-Liedke
- Department of Macromolecular Physics, Adam Mickiewicz University, 61-614, Poznan, Poland
| | - Paulina Cegla
- Department of Nuclear Medicine, Greater Poland Cancer Centre, 61-866, Poznan, Poland.
| | | | - Ewelina Konstanty
- Department of Medical Physics, Greater Poland Cancer Centre, 61-866, Poznan, Poland
| | - Adam Piotrowski
- Department of Macromolecular Physics, Adam Mickiewicz University, 61-614, Poznan, Poland
| | - Magdalena Gross
- Department of Macromolecular Physics, Adam Mickiewicz University, 61-614, Poznan, Poland
| | - Julian Malicki
- Department of Medical Physics, Greater Poland Cancer Centre, 61-866, Poznan, Poland
- Chair, Department of Electroradiology, Poznan University of Medical Science, 61-701, Poznan, Poland
| | - Maciej Kozak
- Department of Macromolecular Physics, Adam Mickiewicz University, 61-614, Poznan, Poland
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Garau LM, Manca G, Bola S, Aringhieri G, Faggioni L, Volterrani D. Correlation between 18F-FDG PET/CT and diffusion-weighted MRI parameters in head and neck squamous cell carcinoma at baseline and after chemo-radiotherapy. A retrospective single institutional study. Oral Radiol 2021; 38:199-209. [PMID: 34133000 DOI: 10.1007/s11282-021-00545-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The relationship between glucose metabolism and tumor cellularity before chemo-radiotherapy in patients with head and neck squamous cell carcinoma (SCC) has never been compared with that of patients evaluated after treatment. This retrospective study analyzed the correlation between glucose metabolism parameters expressed by standardized uptake value (SUV) derived from 18F-fluorodeoxyglucose (18F-FDG) PET/CT and cellularity tumor parameters expressed by apparent diffusion coefficients (ADC) derived from diffusion-weighted (DW) MRI in untreated and treated patients with head and neck SCC. METHODS In 19 patients with no previous exposure to any treatment and 17 different chemo-radiotreated patients with head and neck SCC, we correlated the semi-quantitative uptake values (SUVmax, SUVpeak, and SUVmean) with the ADC functional parameters (ADCmin, ADCmean) including the standard deviation of ADC values (ADCsd). RESULTS No significant correlation was found between glucose metabolism parameters and ADCmin or ADCmean in untreated and treated patient groups. However, in untreated patients, significant inverse correlations were found between ADCsd and SUVmax (P = 0.039, r = -0.476), SUVpeak (P = 0.003, r = -0.652) and SUVmean (P = 0.039, r = -0.477). Analyses after chemo-radiotherapy in 17 patients showed no significant correlation between glucose metabolism parameters and DW MRI values, excluding a persistent significant (but lower intensity) inverse correlation between SUVpeak and ADCsd (P = 0.033, r = -0.519). CONCLUSIONS The demonstrated relationships suggest complex interactions especially between metabolic activity and heterogeneity of tumoral tissue, which might play a complementary role in the assessment of head and neck SCC. TRIAL DATE OF REGISTRATION AND REGISTRATION NUMBER Our retrospective study was registered on April 9th, 2020 by the Ethics Committee of the Coordinating Center "Area Vasta Nord Ovest" (CEAVNO) with Registration Number CEAVNO09042020.
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Affiliation(s)
- Ludovico M Garau
- Department of Radiology, Nuclear Medicine Unit, University Hospital of Parma, Parma, Italy.
- Regional Center of Nuclear Medicine, University Hospital of Pisa, Pisa, Italy.
| | - Gianpiero Manca
- Regional Center of Nuclear Medicine, University Hospital of Pisa, Pisa, Italy
| | - Stefano Bola
- Department of Radiology, Nuclear Medicine Unit, University Hospital of Parma, Parma, Italy
- Regional Center of Nuclear Medicine, University Hospital of Pisa, Pisa, Italy
| | - Giacomo Aringhieri
- Regional Center of Nuclear Medicine, University Hospital of Pisa, Pisa, Italy
| | - Lorenzo Faggioni
- Diagnostic and Interventional Radiology, University Hospital of Pisa, Pisa, Italy
| | - Duccio Volterrani
- Regional Center of Nuclear Medicine, University Hospital of Pisa, Pisa, Italy
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Jinnouchi H, Yamashita H, Kiritoshi T, Miki Y, Katano A, Nakagawa K, Abe O. Prognostic value of pre-treatment maximum standardized uptake value and CRP in radiotherapy of esophageal cancer. Mol Clin Oncol 2021; 15:146. [PMID: 34094544 DOI: 10.3892/mco.2021.2308] [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: 08/21/2020] [Accepted: 04/01/2021] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to evaluate the prognostic value of the pre-treatment maximum standardized uptake value (SUVmax) and CRP in patients who underwent chemoradiotherapy for esophageal squamous cell carcinoma. A retrospective review of 69 consecutive patients with esophageal cancer who underwent concurrent chemoradiotherapy between 2013 and 2016 was performed. The total radiotherapy doses were 50, 50.4 or 60 Gy. The endpoints of the present study were overall survival (OS) and disease-free survival (DFS). The median follow-up for censored cases was 45.7 months. In 56 patients, 18F-fluorodeoxyglucose positron emission tomography was performed within 1 month prior to chemoradiotherapy. Data on CRP within 1 month prior to chemoradiotherapy were available for all patients. In the group of SUVmax >12.85, the rates of 2-year OS and DFS were 49.0 and 35.7%, respectively. In the group of SUVmax ≤12.85, these values were 72.4 and 67.1%, respectively (P=0.048 and P=0.057, respectively). In the group of CRP ≥1 mg/dl, these percentages were 38.5 and 25.0%, respectively. In the group of CRP <1 mg/dl, these rates were 71.2 and 59.7%, respectively (P=0.013 and P<0.001, respectively). A multivariate analysis revealed that pre-treatment serum CRP levels remained an independent prognostic factor for both OS and DFS [OS: hazard ratio (HR), 0.25, P=001; DFS: HR, 0.28, P=0.005]. In conclusion, high SUVmax was associated with lower OS, while high CRP was associated with lower OS and DFS.
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Affiliation(s)
- Haruka Jinnouchi
- Department of Radiology, University of Tokyo Hospital, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hideomi Yamashita
- Department of Radiology, University of Tokyo Hospital, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Tomoki Kiritoshi
- Department of Radiology, University of Tokyo Hospital, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Yosuke Miki
- Department of Radiology, University of Tokyo Hospital, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Atsuto Katano
- Department of Radiology, University of Tokyo Hospital, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Keiichi Nakagawa
- Department of Radiology, University of Tokyo Hospital, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Osamu Abe
- Department of Radiology, University of Tokyo Hospital, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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Prognostic value of metabolic tumor volume and total lesion glycolysis in breast cancer: a meta-analysis. Nucl Med Commun 2021; 41:824-829. [PMID: 32516244 DOI: 10.1097/mnm.0000000000001227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES PET using F-fluorodeoxyglucose (FDG) has proven to be valuable in staging and monitoring of treatment response in breast cancer. We aimed to assess the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with breast cancer. METHODS A systematic search of MEDLINE and EMBASE was performed using the keywords of breast cancer, PET, and volume. Inclusion criteria were F-FDG PET used as an initial imaging tool; studies limited to patients with breast cancer who had not undergone any treatment before PET scans; and studies reporting survival data. Event-free survival (EFS) and overall survival (OS) were considered markers of outcome. RESULTS Nine studies comprising 975 patients were included in this study. The pooled hazard ratio (HR) for adverse events was 33.73 (P < 0.00001; I = 0%) with MTV from primary tumor and 2.89 (P < 0.00001; I = 45%) with TLG from primary tumor, meaning that primary tumors with high volumetric parameters were associated with progression or recurrence. However, the combined HRs for EFS of MTV, and TLG, and those for OS of MTV from whole-body tumor were NS. The pooled HR for OS of TLG from whole-body tumor was 2.95 (P = 0.18; I = 71%). CONCLUSION Volumetric parameters from F-FDG PET are significant prognostic factors for outcome in patients with breast cancer. Patients with a high MTV or TLG from primary tumor have a higher risk of adverse events. Patients with a high TLG from whole-body tumor have a higher risk of deaths.
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Creff G, Devillers A, Depeursinge A, Palard-Novello X, Acosta O, Jegoux F, Castelli J. Evaluation of the Prognostic Value of FDG PET/CT Parameters for Patients With Surgically Treated Head and Neck Cancer: A Systematic Review. JAMA Otolaryngol Head Neck Surg 2021; 146:471-479. [PMID: 32215611 DOI: 10.1001/jamaoto.2020.0014] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Head and neck squamous cell cancer (HNSCC) represents the seventh most frequent cancer worldwide. More than half of the patients diagnosed with HNSCC are treated with primary surgery. Objective To report the available evidence on the value of quantitative parameters of fluorodeoxyglucose F 18-labeled positron emission tomography and computed tomography (FDG-PET/CT) performed before surgical treatment of HNSCC to estimate overall survival (OS), disease-free survival (DFS), and distant metastasis (DM) and to discuss their limitations. Evidence Review A systematic review of the English-language literature in PubMed/MEDLINE and ScienceDirect published between January 2003 and February 15, 2019, was performed between March 1 and July 27, 2019, to identify articles addressing the association between preoperative FDG-PET/CT parameters and oncological outcomes among patients with HNSCC. Articles included those that addressed the following: (1) cancer of the oral cavity, oropharynx, hypopharynx, or larynx; (2) surgically treated (primary or for salvage); (3) pretreatment FDG-PET/CT; (4) quantitative or semiquantitative evaluation of the FDG-PET/CT parameters; and (5) the association between the value of FDG-PET/CT parameters and clinical outcomes. Quality assessment was performed using the Oxford Centre for Evidence-Based Medicine level of evidence. Findings A total of 128 studies were retrieved from the databases, and 36 studies met the inclusion criteria; these studies comprised 3585 unique patients with a median follow-up of 30.6 months (range, 16-53 months). Of these 36 studies, 32 showed an association between at least 1 FDG-PET/CT parameter and oncological outcomes (OS, DFS, and DM). The FDG-PET/CT volumetric parameters (metabolic tumor volume [MTV] and total lesion glycolysis [TLG]) were independent prognostic factors in most of the data, with a higher prognostic value than the maximum standard uptake value (SUVmax). For example, in univariate analysis of OS, the SUVmax was correlated with OS in 5 of 11 studies, MTV in 11 of 12 studies, and TLG in 6 of 9 studies. The spatial distribution of metabolism via textural indices seemed promising, although that factor is currently poorly evaluated: only 3 studies analyzed data from radiomics indices. Conclusions and Relevance The findings of this study suggest that the prognostic effectiveness of FDG-PET/CT parameters as biomarkers of OS, DFS, and DM among patients with HNSCC treated with surgery may be valuable. The volumetric parameters (MTV and TLG) seemed relevant for identifying patients with a higher risk of postsurgical disease progression who could receive early therapeutic intervention to improve their prognosis. However, further large-scale studies including exclusively surgery-treated patients stratified according to localization and further analysis of the textural indices are required to define a reliable FDG-PET/CT-based prognostic model of mortality and recurrence risk for these patients.
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Affiliation(s)
- Gwenaelle Creff
- Department of Otolaryngology-Head and Neck Surgery, Rennes University Hospital, Rennes, France
| | - Anne Devillers
- Department of Nuclear Medicine, Centre Eugène Marquis, Rennes, France
| | - Adrien Depeursinge
- University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | | | - Oscar Acosta
- LTSI (Image and Signal Processing Laboratory), INSERM, U1099, Rennes, France
| | - Franck Jegoux
- Department of Otolaryngology-Head and Neck Surgery, Rennes University Hospital, Rennes, France
| | - Joel Castelli
- Department of Radiation Oncology, Cancer Institute Eugène Marquis, Rennes, France
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Batuwitage BT, Hanlon R, Charters P. Imaging in head and neck cancers. BJA Educ 2021; 21:2-9. [PMID: 33456968 DOI: 10.1016/j.bjae.2020.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- B T Batuwitage
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - R Hanlon
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - P Charters
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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21
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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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Chandel V, Raj S, Kumar P, Gupta S, Dhasmana A, Kesari KK, Ruokolainen J, Mehra P, Das BC, Kamal MA, Kumar D. Metabolic regulation in HPV associated head and neck squamous cell carcinoma. Life Sci 2020; 258:118236. [PMID: 32795537 DOI: 10.1016/j.lfs.2020.118236] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/25/2020] [Accepted: 08/05/2020] [Indexed: 12/13/2022]
Abstract
Cancer cells exhibit distinct energy metabolic pathways due to multiple oncogenic events. In normoxia condition, the anaerobic glycolysis (Warburg effect) is highly observed in head and neck squamous cell carcinoma (HNSCC). HNSCC is associated with smoking, chewing tobacco, consumption of alcohol or Human Papillomavirus (HPV) infection primarily HPV16. In recent years, the correlation of HPV with HNSCC has significantly expanded. Despite the recent advancement in therapeutic approaches, the rate of HPV infected HNSCC has significantly increased in the last few years, specifically, in lower middle-income countries. The oncoproteins of High-risk Human Papillomavirus (HR-HPV), E6 and E7, alter the metabolic phenotype in HNSCC, which is distinct from non-HPV associated HNSCC. These oncoproteins, modulate the cell cycle and metabolic signalling through interacting with tumor suppressor proteins, p53 and pRb. Since, metabolic alteration represents a major hallmark for tumorigenesis, HPV acts as a source of biomarker linked to cancer progression in HNSCC. The dependency of cancer cells to specific nutrients and alteration of various metabolic associated genes may provide a unique opportunity for pharmacological intervention in HPV infected HNSCC. In this review, we have discussed the molecular mechanism (s) and metabolic regulation in HNSCC depending on the HPV status. We have also discussed the possible potential therapeutic approaches for HPV associated HNSCC through targeting metabolic pathways.
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Affiliation(s)
- Vaishali Chandel
- Amity Institute of Molecular Medicine and Stem Cell Research (AIMMSCR), Amity University UttarPradesh, Sec 125, Noida 201303, India
| | - Sibi Raj
- Amity Institute of Molecular Medicine and Stem Cell Research (AIMMSCR), Amity University UttarPradesh, Sec 125, Noida 201303, India
| | - Prabhat Kumar
- Amity Institute of Molecular Medicine and Stem Cell Research (AIMMSCR), Amity University UttarPradesh, Sec 125, Noida 201303, India
| | - Shilpi Gupta
- Amity Institute of Molecular Medicine and Stem Cell Research (AIMMSCR), Amity University UttarPradesh, Sec 125, Noida 201303, India
| | - Anupam Dhasmana
- Himalayan School of Biosciences, Swami Rama Himalayan University, Swami Ram Nagar, Jolly Grant, Doiwala, Dehradun 248016, India; Department of Immunology and Microbiology, School of Medicine, University of Rio Grande Valley, McAllen, TX, USA
| | - Kavindra Kumar Kesari
- Department of Applied Physics, School of Science, Aalto University, Espoo 02150, Finland
| | - Janne Ruokolainen
- Department of Applied Physics, School of Science, Aalto University, Espoo 02150, Finland
| | - Pravesh Mehra
- Department of Oral and Maxillofacial surgery, Lady Hardinge Medical College, New Delhi, India
| | - Bhudev C Das
- Amity Institute of Molecular Medicine and Stem Cell Research (AIMMSCR), Amity University UttarPradesh, Sec 125, Noida 201303, India
| | - Mohammad Amjad Kamal
- King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia; Enzymoics, 7 Peterlee Place, Hebersham, NSW 2770, Australia; Novel Global Community Educational Foundation, NSW, Australia
| | - Dhruv Kumar
- Amity Institute of Molecular Medicine and Stem Cell Research (AIMMSCR), Amity University UttarPradesh, Sec 125, Noida 201303, India.
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Elhalawani H, Awan MJ, Ding Y, Mohamed ASR, Elsayes AK, Abu-Gheida I, Wang J, Hazle J, Gunn GB, Lai SY, Frank SJ, Ginsberg LE, Rosenthal DI, Fuller CD. Data from a terminated study on iron oxide nanoparticle magnetic resonance imaging for head and neck tumors. Sci Data 2020; 7:63. [PMID: 32081849 PMCID: PMC7035252 DOI: 10.1038/s41597-020-0392-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023] Open
Abstract
Node positive head and neck squamous cell carcinomas (HNSCCs) patients exhibit worse outcomes in terms of regional neck control, risk for distant metastases and overall survival. Smaller non-palpable lymph nodes may be inflammatory or may harbor clinically occult metastases, a characterization that can be challenging to make using routine imaging modalities. Ferumoxytol has been previously investigated as an intra-tumoral contrast agent for magnetic resonance imaging (MRI) for intracranial malignancies and lymph node agent in prostate cancer. Hence, our group was motivated to carry out a prospective feasibility study to assess the feasibility of ferumoxytol dynamic contrast enhanced (DCE)-weighted MRI relative to that of gadolinium-based DCE-MRI for nodal and primary tumor imaging in patients with biopsy-proven node-positive HNSCC or melanoma. Although this institutional review board (IRB)-approved study was prematurely terminated because of an FDA black box warning, the investigators sought to curate and publish this unique dataset of matched clinical, and anatomical and DCE MRI data for the enrolled five patients to be available for scientists interested in molecular imaging. Measurement(s) | imaging assay • head and neck squamous cell carcinoma | Technology Type(s) | magnetic resonance imaging | Factor Type(s) | contrast agent | Sample Characteristic - Organism | Homo sapiens |
Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.11409516
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Affiliation(s)
- Hesham Elhalawani
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Musaddiq J Awan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Radiation Oncology, Medical College of Wisconsin, Wisconsin, USA
| | - Yao Ding
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,MD Anderson Cancer Center UThealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Ahmed K Elsayes
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ibrahim Abu-Gheida
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Radiation Oncology, Burjeel Medical City, Abu-Dhabi, UAE
| | - Jihong Wang
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John Hazle
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen Y Lai
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lawrence E Ginsberg
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. .,Department of Radiation Physics, Graduate School of Biomedical Sciences, MD Anderson Cancer Center, Houston, TX, USA.
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24
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Ohashi T, Terasawa K, Aoki M, Akazawa T, Shibata H, Kuze B, Asano T, Kato H, Miyazaki T, Matsuo M, Inoue N, Ito Y. The importance of FDG-PET/CT parameters for the assessment of the immune status in advanced HNSCC. Auris Nasus Larynx 2020; 47:658-667. [PMID: 32089351 DOI: 10.1016/j.anl.2020.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 12/24/2019] [Accepted: 01/14/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Cancer cells secrete large amounts of lactic acid via aerobic glycolysis. We have shown that lactic acid plays an important role as a proinflammatory and immunosuppressive mediator and promotes tumor progression. Fluorine-18 fluorodeoxyglucose (FDG) uptake detected by positron emission tomography/computed tomography (PET/CT) is considered as a good indicator of aerobic glycolysis in cancer. In this study, we examined the relationships between systemic inflammatory parameters and FDG-PET/CT parameters in advanced head and neck squamous cell carcinoma (HNSCC). Furthermore, we investigated the relationships between FDG-PET/CT parameters and M2-macrophage polarization in HNSCC by assessing the ratio of CD163, a M2-macrophage marker, to CD68, a pan-macrophage marker. METHODS This study included 73 advanced HNSCC patients. We assessed the C-reactive protein (CRP) level, white blood cell (WBC) count, neutrophil count, lymphocyte count, and monocyte count as systemic inflammatory markers. Additionally, we assessed the maximum standardized uptake value (SUVmax), mean SUV (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) as FDG-PET/CT parameters. RESULTS The CRP level, WBC count, and neutrophil count were correlated with whole-body FDG-PET/CT parameters. The CD163/CD68 ratio was correlated with SUVmax and SUVmean. Our results suggest that systemic inflammation, which is associated with neutrophils, develops in patients with HNSCC having tumors with a larger volume and increased glucose uptake and that M2-macrophage polarization is promoted in HNSCC with increased glucose uptake, SUVmax, and SUVmean. FDG-PET/CT has the potential to reflect cancer-related chronic inflammation and immunosuppressive conditions in cancer patients. CONCLUSIONS FDG-PET/CT parameters appear to be useful in assessing the immune status in HNSCC.
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Affiliation(s)
- Toshimitsu Ohashi
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Yanagido, Gifu, Gifu 501-1194, Japan.
| | - Kousuke Terasawa
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Yanagido, Gifu, Gifu 501-1194, Japan
| | - Mitsuhiro Aoki
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Yanagido, Gifu, Gifu 501-1194, Japan
| | - Takashi Akazawa
- Department of Tumor Immunology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan
| | - Hirofumi Shibata
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Yanagido, Gifu, Gifu 501-1194, Japan
| | - Bunya Kuze
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Yanagido, Gifu, Gifu 501-1194, Japan
| | - Takahiko Asano
- Department of Radiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | | | - Masayuki Matsuo
- Department of Radiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Norimitsu Inoue
- Department of Tumor Immunology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan; Department of Molecular Genetics, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan.
| | - Yatsuji Ito
- Department of Otolaryngology, Gifu University Graduate School of Medicine, Yanagido, Gifu, Gifu 501-1194, Japan
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25
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Adams LC, Bressem KK, Brangsch J, Reimann C, Nowak K, Brenner W, Makowski MR. Quantitative 3D Assessment of 68Ga-DOTATOC PET/MRI with Diffusion-Weighted Imaging to Assess Imaging Markers for Gastroenteropancreatic Neuroendocrine Tumors: Preliminary Results. J Nucl Med 2019; 61:1021-1027. [PMID: 31862798 DOI: 10.2967/jnumed.119.234062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 11/13/2019] [Indexed: 01/09/2023] Open
Abstract
68Ga-DOTATOC PET/MRI combines the advantages of PET in the acquisition of metabolic-functional information with the high soft-tissue contrast of MRI. SUVs in tumors have been suggested to be a measure of somatostatin receptor expression. A challenge with receptor ligands is that the distribution volume is confined to tissues with tracer uptake, potentially limiting SUV quantification. In this study, various functional 3-dimensional SUV apparent diffusion coefficient (ADC) parameters and arterial tumor enhancement were tested for ability to characterize gastroenteropancreatic (GEP) neuroendocrine tumors (NETs). Methods: For this single-center, cross-sectional study, 22 patients with 24 histologically confirmed GEP NET lesions (15 men and 7 women; median age, 61 y; range, 43-81 y) who underwent hybrid 68Ga-DOTA PET/MRI at 3 T between January 2017 and July 2019 met the eligibility criteria. SUV, tumor-to-background ratio, total functional tumor volume, and mean and minimum ADC were measured on the basis of volumes of interest and examined with receiver-operating-characteristic analysis to determine cutoffs for differentiation between low- and intermediate-grade GEP NETs. The Spearman rank correlation coefficient was used to assess correlations between functional imaging parameters. Results: The ratio of PET-derived SUVmean and diffusion-weighted imaging-derived minimum ADC was introduced as a combined variable to predict tumor grade, outperforming single predictors. On the basis of a threshold ratio of 0.03, tumors could be classified as grade 2 with a sensitivity of 86% and a specificity of 100%. SUV and functional ADCs, as well as arterial contrast enhancement parameters, showed nonsignificant and mostly negligible correlations. Conclusion: Because receptor density and tumor cellularity appear to be independent, potentially complementary phenomena, the combined ratio of PET/MRI and SUVmean/ADCmin may be used as a novel biomarker allowing differentiation between grade 1 and grade 2 GEP NETs.
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Affiliation(s)
- Lisa C Adams
- Department of Radiology Charité, Berlin, Germany; and
| | | | | | | | - Kristin Nowak
- Department of Radiology Charité, Berlin, Germany; and
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26
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Lv W, Ashrafinia S, Ma J, Lu L, Rahmim A. Multi-Level Multi-Modality Fusion Radiomics: Application to PET and CT Imaging for Prognostication of Head and Neck Cancer. IEEE J Biomed Health Inform 2019; 24:2268-2277. [PMID: 31804945 DOI: 10.1109/jbhi.2019.2956354] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To characterize intra-tumor heterogeneity comprehensively, we propose a multi-level fusion strategy to combine PET and CT information at the image-, matrix-and feature-levels towards improved prognosis. Specifically, we developed fusion radiomics in the context of 3 prognostic outcomes in a multi-center setting (4 centers) involving 296 head & neck cancer patients. Eight clinical parameters were first utilized to build a (1) clinical model. We also built models by extracting 127 radiomics features from (2) PET images alone; (3-8) PET and CT images fused via wavelet-based fusion (WF) using CT-weights of 0.2, 0.4, 0.6 and 0.8, gradient transfer fusion (GTF), and guided filtering-based fusion (GFF); (9) fused matrices (sumMat); (10-11) fused features constructed via feature averaging (avgFea) and feature concatenation (conFea); and finally, (12) CT images alone; above models were also expanded to include both clinical and radiomics features. Seven variations of training and testing partitions were investigated. Highest performance in 5, 6 and 5 partitions was achieved by image-level fusion strategies for RFS, MFS and OS prediction, respectively. Among all partitions, WF0.6 and WF0.8 showed significantly higher performance than CT model for RFS (C-index: 0.60 ± 0.04 vs. 0.56 ± 0.03, p-value: 0.015) and MFS (C-index: 0.71 ± 0.13 vs. 0.62 ± 0.08, p-value: 0.020) predictions, respectively. In partition CER 23 vs. 14, WF0.6 significantly outperformed Clinical model for RFS prediction (C-index: 0.67 vs. 0.53, p-value: 0.003); both avgFea and WF0.6 showed C-index of 0.64 and significantly higher than that of PET only (C-index: 0.51, p-value: 0.018 and 0.031, respectively) for OS prediction. Fusion radiomics modeling showed varying improvements compared to single modality models for different outcome predictions in different partitions, highlighting the importance of generalizing radiomics models. Image-level fusion holds potential to capture more useful characteristics.
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27
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Traylor KS, Koontz N, Mosier K. Squamous Cell Carcinoma: PET/CT and PET/MRI of the Pretreatment and Post-Treatment Neck. Semin Ultrasound CT MR 2019; 40:400-413. [DOI: 10.1053/j.sult.2019.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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28
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Economopoulou P, de Bree R, Kotsantis I, Psyrri A. Diagnostic Tumor Markers in Head and Neck Squamous Cell Carcinoma (HNSCC) in the Clinical Setting. Front Oncol 2019; 9:827. [PMID: 31555588 PMCID: PMC6727245 DOI: 10.3389/fonc.2019.00827] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/12/2019] [Indexed: 12/19/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) represents a group of tumors arising in the oral cavity, oropharynx, and larynx. Although HNSCC is traditionally associated with tobacco and alcohol consumption, a growing proportion of head and neck tumors, mainly of the oropharynx, are associated with Human Papilloma Virus (HPV). Recurrent/metastatic disease is characterized by dismal prognosis and there is an unmet need for the development of biomarkers for detection of early disease, accurate prediction of prognosis, and appropriate selection of therapy. Based on the REMARK guidelines, a variety of diagnostic and prognostic biomarkers are being evaluated in clinical trials but their clinical significance is doubtful. Herein, we will focus on biomarkers in HNSCC used in the clinical setting and we will illustrate their clinical relevance.
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Affiliation(s)
- Panagiota Economopoulou
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Ioannis Kotsantis
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Amanda Psyrri
- Section of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
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29
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Srinivas KS, Arunan M, Venkatachalapathy E, John C, Manickavasagam M, Divyambika CV. The Prognostic Role of Maximum Standardized Uptake Value of 18 F-FlouroDeoxy Glucose Positron Emission Tomography-Computed Tomography in Head and Neck Cancer Patients Undergoing Chemoradiotherapy. J Int Soc Prev Community Dent 2019; 9:159-165. [PMID: 31058066 PMCID: PMC6489513 DOI: 10.4103/jispcd.jispcd_409_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/08/2019] [Indexed: 02/03/2023] Open
Abstract
Aims and Objectives: This retrospective study aims at correlating the pre- and post-therapy maximal standardized uptake values (SUVmax) of the whole-body 18-flourodeoxy glucose positron emission tomography (FDG-PET) scan with tumor response in patients with head and neck squamous cell cancer undergoing chemoradiotherapy. Materials and Methods: Data for this retrospective study were taken from the clinical records of 20 evaluable head and neck cancer patients who had availed treatment and evaluation at our institute during the previous year (March 2017–April 2018). All these above-mentioned patients had undergone chemoradiation at our center for locally advanced squamous cell carcinoma of the head and neck and had undergone pre- and post-therapy whole-body FDG PET scan. The posttherapy PET-computed tomography (CT) was advised after 8 weeks’ postcompletion of therapy. During the PET CT scan, images were acquired 1 h after injection of FDG. Pre- and post-therapy SUVmax were recorded and correlated with immediate treatment response. Results: The mean pretherapy SUVMax of the primary tumor was 10.27 ranging from 4.5 to 26.17. The mean pretherapy SUVMax of the node was 5.34 ranging from 0 to 17.9. The mean time of recording the posttherapy SUVMax was 3 months (range 2–5 months). The mean posttherapy SUVMax of the primary tumor was 1.05 ranging from complete metabolic response to 6.4. The mean posttherapy SUVMax of the node was 0.7 ranging from complete metabolic response to 5.43. The statistical analysis based on Wilcoxon–Signed Rank test revealed a statistically significant difference in the pre- and post-therapy SUVmax values for both primary tumor (P < 0.001) and regional node (P = 0.001). Majority of patients (n = 15) showed clinical remission; however, five patients had progressive disease at the time of evaluation. Conclusion: Although the retrospective study revealed that complete responders had a statistically significant reduction in the posttherapy SUVmax in comparison to the pretherapy SUVmax it failed to identify a cutoff value for pretherapy SUVmax which could predict the probable outcome of therapy. In view of the same further prospective studies need to be conducted with larger patient numbers including various other tumor metabolic markers for greater clarity.
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Affiliation(s)
- Kondaveeti Satish Srinivas
- Department of Radiotherapy, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - M Arunan
- Department of Radiology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - E Venkatachalapathy
- Department of Nuclear Medicine, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Christopher John
- Department of Radiotherapy, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - M Manickavasagam
- Department of Medical Oncology, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - C V Divyambika
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
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30
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Prognostic value of 18F-FDG PET/CT functional parameters in patients with head and neck cancer. Nucl Med Commun 2019; 40:361-369. [DOI: 10.1097/mnm.0000000000000974] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Martens RM, Noij DP, Koopman T, Zwezerijnen B, Heymans M, de Jong MC, Hoekstra OS, Vergeer MR, de Bree R, Leemans CR, de Graaf P, Boellaard R, Castelijns JA. Predictive value of quantitative diffusion-weighted imaging and 18-F-FDG-PET in head and neck squamous cell carcinoma treated by (chemo)radiotherapy. Eur J Radiol 2019; 113:39-50. [PMID: 30927958 DOI: 10.1016/j.ejrad.2019.01.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/28/2018] [Accepted: 01/29/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND PURPOSE In head and neck squamous cell carcinoma (HNSCC) (chemo)radiotherapy is increasingly used to preserve organ functionality. The purpose of this study was to identify predictive pretreatment DWI- and 18F-FDG-PET/CT-parameters for treatment failure (TF), locoregional recurrence (LR) and death in HNSCC patients treated by (chemo)radiotherapy. MATERIALS AND METHODS We retrospectively included 134 histologically proven HNSCC patients treated with (chemo)radiotherapy between 2012-2017. In 58 patients pre-treatment DWI and 18F-FDG-PET/CT were performed, in 31 patients DWI only and in 45 patients 18F-FDG-PET/CT only. Primary tumor (PT) and largest lymph node (LN) metastasis were quantitatively assessed for TF, LR and death. Multivariate analysis was performed for 18F-FDG-PET/CT and DWI separately and thereafter combined. In patients with both imaging modalities, positive and negative predictive value in TF and differences in LR and death, were assessed. RESULTS Mean follow-up was 25.6 months (interquartile-range; 14.0-37.1 months). Predictors of treatment failure, corrected for TNM-stage and HPV-status, were SUVmax-PT, ADCmax-PT, total lesion glycolysis (TLG-LN), ADCp20-LN (P = 0.049, P = 0.024, P = 0.031, P = 0.047, respectively). TLG-PT was predictive for LR (P = 0.003). Metabolic active tumor volume (MATV-PT) (P = 0.003), ADCGTV-PT (P < 0.001), ADCSD (P = 0.048) were significant predictors for death. In patients with both imaging modalities SUVmax-PT remained predictive for treatment failure (P = 0.049), TLG-LN for LR (P = 0.003) and ADCGTV-PT for death (P < 0.001). Higher predictive value for treatment failure was found for the combination of SUVmax-PT and ADCmax-PT, compared to either one separately. CONCLUSION Both DWI- and 18F-FDG-PET/CT-parameters appear to have predictive value for treatment failure, locoregional recurrence and death. Combining SUVmax-PT and ADCmax-PT resulted in better prediction of treatment failure compared to single parameter assessment.
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Affiliation(s)
- Roland M Martens
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands.
| | - Daniel P Noij
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Thomas Koopman
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Ben Zwezerijnen
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Martijn Heymans
- Department of Epidemiology and Biostatistics, the Netherlands
| | - Marcus C de Jong
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Otto S Hoekstra
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Marije R Vergeer
- Department of Radiation Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Remco de Bree
- Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, Amsterdam, the Netherlands; Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - C René Leemans
- Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, Amsterdam, the Netherlands
| | - Pim de Graaf
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Jonas A Castelijns
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
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Ozturk K, Gencturk M, Caicedo-Granados E, Li F, Cayci Z. Performance of whole-body 18F-FDG PET/CT as a posttreatment surveillance tool for sinonasal malignancies. Eur Arch Otorhinolaryngol 2019; 276:847-855. [PMID: 30604061 DOI: 10.1007/s00405-018-05272-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 12/24/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE To determine the diagnostic utility of posttreatment surveillance whole-body 18F-FDG PET/CT in detecting local tumor recurrence (R), regional lymph-node metastasis (LM), and distant metastasis (DM) in asymptomatic sinonasal cancer patients. METHODS Eighty consecutive patients (53 men, 27 women; mean age, 60 years; range, 28-92 years) who had undergone 197 posttreatment whole-body 18F-FDG PET/CT examinations for sinonasal malignancies between January 2009 and August 2017 were retrospectively reviewed. 18F-FDG PET/CT findings were categorized as positive or negative for R, LM, and DM, separately. Outcomes of 18F-FDG PET/CT scans were compared with the final diagnosis confirmed by histological analysis or follow-up period for a minimum 12 months. The diagnostic accuracy of scans was calculated for each site using contingency tables. Impact on the management of 18F-FDG PET/CT examinations was additionally evaluated. RESULTS 18F-FDG PET/CT scans identified 37/44 of local recurrences, 21/23 of LMs, and 30/37 of DMs. For local recurrence, sensitivity, specificity, positive predictive value, and negative predictive value were 84% (68-97%), 95% (80-100%), 84% (68-97%), and 95% (80-100%), respectively. For LM, the respective values were 91% (75-100%), 99% (83-100%), 91% (75-100%), and 99% (83-100%). For DM, the values were 81% (64-97%), 99% (85-100%), 97% (81-100%), and 96% (81-100%), respectively. 18F-FDG PET/CT accounted for a change in management of 85% patients with recurrences. CONCLUSIONS Whole-body 18F-FDG PET/CT is a suitable surveillance tool for sinonasal malignancies in detecting locoregional and distant recurrences in asymptomatic patients without any evidence of recurrence on regular follow-up and endoscopy during the posttreatment period.
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Affiliation(s)
- Kerem Ozturk
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - Mehmet Gencturk
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - Emiro Caicedo-Granados
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - Faqian Li
- Department of Pathology and Laboratory Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - Zuzan Cayci
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, MN, USA.
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Guezennec C, Robin P, Orlhac F, Bourhis D, Delcroix O, Gobel Y, Rousset J, Schick U, Salaün PY, Abgral R. Prognostic value of textural indices extracted from pretherapeutic 18-F FDG-PET/CT in head and neck squamous cell carcinoma. Head Neck 2018; 41:495-502. [PMID: 30549149 DOI: 10.1002/hed.25433] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/20/2018] [Accepted: 09/21/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND This study aimed at assessing the prognostic value of textural indices extracted from 18F-fluorodeoxyglucose positron-emission tomography (FDG-PET)/CT in a large cohort of patients with head and neck squamous cell carcinomas (HNSCC) of any anatomic subsite and staging. METHODS Consecutive patients with HNSCC referred for a pretreatment FDG-PET/CT were retrospectively included and followed up for a minimum of 2 years. Standardized uptake value, metabolic tumor volume (MTV), and textural indices were calculated using LIFEx software. Prognostic significance of parameters was assessed in univariate and multivariate analysis. RESULTS Textural indices were extracted in 284 patients (mean age = 63.7±9.6 years). In univariate analysis, MTV and 4 textural indices-Correlation, Entropy, Energy, and Coarseness-were significantly correlated with overall survival (OS). In multivariate analysis, MTV (P = .008) and Correlation (P = .028) remained independently correlated to OS. CONCLUSION This study showed that MTV and 1 textural index extracted from pretherapeutic FDG-PET/CT (Correlation) were independent prognostic factors of OS in patients with HNSCC.
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Affiliation(s)
| | - Philippe Robin
- Department of Nuclear Medicine, Brest University Hospital, Brest, France
| | - Fanny Orlhac
- Imagerie Moléculaire in Vivo, CEA-SHJF, Inserm, CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay, France
| | - David Bourhis
- Department of Nuclear Medicine, Brest University Hospital, Brest, France
| | - Olivier Delcroix
- Department of Nuclear Medicine, Brest University Hospital, Brest, France
| | - Yves Gobel
- Department of Head and Neck Surgery, Brest University Hospital, Brest, France
| | - Jean Rousset
- Department of Radiology, Military Hospital Brest, Brest, France
| | - Ulrike Schick
- Department of Radiotherapy, Brest University Hospital, Brest, France
| | - Pierre-Yves Salaün
- Department of Nuclear Medicine, Brest University Hospital, Brest, France
| | - Ronan Abgral
- Department of Nuclear Medicine, Brest University Hospital, Brest, France
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Use of 18F-FDG PET/CT Imaging for Radiotherapy Target Volume Delineation after Induction Chemotherapy and for Prognosis of Locally Advanced Squamous Cell Carcinoma of the Head and Neck. ACTA ACUST UNITED AC 2018; 54:medicina54060107. [PMID: 30544718 PMCID: PMC6306774 DOI: 10.3390/medicina54060107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 11/23/2018] [Accepted: 11/29/2018] [Indexed: 12/12/2022]
Abstract
Background and objectives: Induction chemotherapy (ICT) before definitive chemoradiation (CRT) gives high response rates in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, pre-ICT gross tumor volume (GTV) for radiotherapy (RT) planning is still recommended. As 18F-FDG PET/CT has an advantage of biological tumor information comparing to standard imaging methods, we aimed to evaluate the feasibility of 18F-FDG PET/CT-based post-ICT GTV delineation for RT planning in LA-SCCHN and to assess the prognostic value of PET parameters: maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Methods: 47 LA-SCCHN patients were treated with 3 cycles of ICT (docetaxel, cisplatin, and 5-fluorouracil) followed by CRT (70 Gy in 35 fractions with weekly cisplatin). Pre- and post-ICT PET/CT examinations were acquired. Planning CT was co-registered with post-ICT PET/CT and RT target volumes were contoured according to post-ICT PET. Post-ICT percentage decrease of SUVmax, MTV and TLG in primary tumor and metastatic regional lymphnodes (LN) was counted. Loco-regional failure patterns, 3-year progression free (PFS) and overall survival (OS) were evaluated. Results: 3-year PFS and OS rates for study population were 67% and 61% respectively. 31.9% of patients progressed loco-regionally. All progress was localized in high-to-intermediate dose (60⁻70 Gy) RT volumes and none in low dose (50 Gy) volumes. Decrease of SUVmax ≥ 74% (p = 0.04), MTV ≥ 68% (p = 0.03), TLG ≥ 76% (p = 0.03) in primary tumor, and LN TLG decrease ≥ 74% (p = 0.03) were associated with PFS. Decrease of primary tumor SUVmax ≥ 74% (p = 0.04), MTV ≥ 69% (p = 0.03), TLG ≥ 74% (p = 0.02) and LN TLG ≥ 73% (p = 0.02) were prognostic factors for OS. Conclusions: According to our results, 18F-FDG PET/CT-based post-ICT GTV delineation is feasible strategy without negative impacts on loco-regional control and survival. Percentage decrease of metabolic PET parameters SUVmax, MTV and TLG has a prognostic value in LA-SCCHN.
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Nie K, Zhang YX, Nie W, Zhu L, Chen YN, Xiao YX, Liu SY, Yu H. Prognostic value of metabolic tumour volume and total lesion glycolysis measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography in small cell lung cancer: A systematic review and meta-analysis. J Med Imaging Radiat Oncol 2018; 63:84-93. [PMID: 30230710 DOI: 10.1111/1754-9485.12805] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 08/17/2018] [Indexed: 01/26/2023]
Abstract
The aim of this study was to evaluate the prognostic value of metabolic tumour volume (MTV) and total lesion glycolysis (TLG) for small cell lung cancer (SCLC). MEDLINE, EMBASE and Cochrane Library databases were systematically searched. The pooled hazard ratio (HR) was used to measure the influence of MTV and TLG on survival. The subgroup analysis according to VALSG stage and the measured extent of MTV was performed. Patients with high MTV values experienced a significantly poorer prognosis with a HR of 2.42 (95% CI 1.46-4.03) for overall survival (OS) and a HR of 2.78 (95% CI 1.39-5.53) for progression-free survival (PFS) from the random effect model, and the pooled HR from the fixed effect model was 2.10 (95% CI 1.77-2.50) for OS and 2.27 (95% CI 1.83-2.81) for PFS. Patients with high TLG experienced a poorer prognosis with a HR of 1.61 (95% CI: 1.24-2.07) for OS from the random effect model, and the pooled HR from the fixed effect model was 1.64 (95% CI 1.37-1.96). Heterogeneity among studies was high for MTV in both OS and PFS meta-analyses (I2 = 87% and 88% respectively). After removing one outlier study the heterogeneity was substantially reduced (I2 = 0%) and the pooled HR for the effect of MTV on OS was 1.80 (1.51-2.16, P < 0.00001), and on PFS it was 1.86 (1.49-2.33, P < 0.00001), using either the fixed or random effects model. High MTV is associated with a significantly poorer prognosis OS and PFS, and high TLG is associated with a significantly poorer prognosis regarding OS for SCLC.
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Affiliation(s)
- Kai Nie
- Department of Imaging and Nuclear Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yu-Xuan Zhang
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, Belfast, UK
| | - Wei Nie
- Department of Respiration, Shanghai Chest Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Lin Zhu
- Department of Imaging and Nuclear Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yi-Nan Chen
- Department of Radiology, Shanghai Chest Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Yong-Xin Xiao
- Department of Imaging and Nuclear Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Shi-Yuan Liu
- Department of Imaging and Nuclear Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Hong Yu
- Department of Imaging and Nuclear Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Department of Radiology, Oriental Hospital Affiliated Tongji University, Shanghai, China
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Meta-analysis of meta-analyses in oncologic positron emission tomography. Nucl Med Commun 2018; 39:1150-1155. [PMID: 30212400 DOI: 10.1097/mnm.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES As PET has become a standard of treatment in patients with cancer, publications of oncologic PET have grown sharply. We aimed to organize the data of meta-analyses of oncologic PET and assess the quality of studies. MATERIALS AND METHODS The inclusion criteria were studies that meta-analyzed to combine the data from multiple studies of oncologic PET. We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to assess the reporting quality of the included studies. RESULTS A total of 254 meta-analyses were eligible for inclusion in the study. The peak number of publications increased up to 42 in 2014. Lung (n=39, 15.4%) is the most common site of tumor included in meta-analysis with oncologic PET. Overall, 84% of studies were categorized into diagnostic test accuracy reviews (n=214). Studies published in 2010 or later (n=213) showed higher PRISMA scores than those published in 2009 or before. CONCLUSION A large number of meta-analyses are published in the field of oncologic PET. Meta-analyses in oncologic PET seem to be cited more often than regular research papers. The overall quality of studies is low; however, they showed improvement after PRISMA statement.
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Pietrzak AK, Kazmierska J, Marszalek A, Cholewinski W. Evaluation of physiologic and abnormal glucose uptake in palatine tonsils: differential diagnostics with sequential dual-time-point 2-deoxy-2-[18F]FDG PET/CT. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2018; 64:299-306. [PMID: 30221906 DOI: 10.23736/s1824-4785.18.03065-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The aim of this article was to evaluate the usefulness of sequential dual-time-point 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (DTP [18F]FDG PET/CT) in distinguishing physiologic, inflammatory and malignant palatine tonsils as difficult to differentiate in the oncological practice. METHODS A total of 90 patients before the treatment underwent sequential DTP [18F]FDG PET/CT examinations. We analyzed 104 structures in 90 patients: 31 physiologic tonsils, 28 histopathologically confirmed inflammatory tonsils of non-specified origin, 31 histopathologically confirmed palatine tonsils cancer and 14 non-malignant contralateral tonsils in patients with histopathologically confirmed unilateral palatine tonsil malignancy. Patients underwent sequential [18F]FDG PET/CT examinations at 60 and 90 minutes post-injection of the [18F]FDG. We analyzed the SUVmax and SUVmean values at 60 and 90 minutes post-injection changes over time and the Retention Index (RI-SUVmax). To find the predictive SUV value and the RI cut-off between physiology, inflammatory and malignancy, we used the ROC analysis. RESULTS The average SUVmax values at 60 and 90minutes post-injection within physiologic palatine tonsils were 1.36±0.26 and 1.31±0.26, respectively, P>0.05. The average SUVmax values at 60 and 90 minutes post-injection within inflammatory and malignant tonsils were 3.74±1.45, 3.80±1.47 (P>0.05) and 5.19±2.19, 5.81±2.50 (P<0.05), respectively. The RI-SUVmax fluctuation over time were 5±28% within physiologic, -4±11% within contralateral non-malignant tonsils in patients with one tonsil involved, 2±11% within inflammatory and 13±13% within malignant tonsils. CONCLUSIONS The sequential dual-time-point [18F]FDG PET/CT examinations may increase the sensitivity and the specificity of the PET/CT method in differential palatine tonsils diagnosis.
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Affiliation(s)
- Agata K Pietrzak
- Department of Nuclear Medicine, Greater Poland Cancer Center, Poznan, Poland -
| | - Joanna Kazmierska
- Department of Electroradiology, University of Medical Science, Poznan, Poland
| | - Andrzej Marszalek
- Poznan University of Medical Sciences, Greater Poland Cancer Center, Poznan, Poland
| | - Witold Cholewinski
- Department of Electroradiology, University of Medical Science, Poznan, Poland
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Imaging features of sinonasal tumors on positron emission tomography and magnetic resonance imaging including diffusion weighted imaging: A pictorial review. Clin Imaging 2018; 51:217-228. [DOI: 10.1016/j.clinimag.2018.05.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/17/2018] [Accepted: 05/24/2018] [Indexed: 11/19/2022]
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Baker LCJ, Sikka A, Price JM, Boult JKR, Lepicard EY, Box G, Jamin Y, Spinks TJ, Kramer-Marek G, Leach MO, Eccles SA, Box C, Robinson SP. Evaluating Imaging Biomarkers of Acquired Resistance to Targeted EGFR Therapy in Xenograft Models of Human Head and Neck Squamous Cell Carcinoma. Front Oncol 2018; 8:271. [PMID: 30083516 PMCID: PMC6064942 DOI: 10.3389/fonc.2018.00271] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 07/02/2018] [Indexed: 01/18/2023] Open
Abstract
Background: Overexpression of EGFR is a negative prognostic factor in head and neck squamous cell carcinoma (HNSCC). Patients with HNSCC who respond to EGFR-targeted tyrosine kinase inhibitors (TKIs) eventually develop acquired resistance. Strategies to identify HNSCC patients likely to benefit from EGFR-targeted therapies, together with biomarkers of treatment response, would have clinical value. Methods: Functional MRI and 18F-FDG PET were used to visualize and quantify imaging biomarkers associated with drug response within size-matched EGFR TKI-resistant CAL 27 (CALR) and sensitive (CALS) HNSCC xenografts in vivo, and pathological correlates sought. Results: Intrinsic susceptibility, oxygen-enhanced and dynamic contrast-enhanced MRI revealed significantly slower baseline R 2 ∗ , lower hyperoxia-induced Δ R 2 ∗ and volume transfer constant Ktrans in the CALR tumors which were associated with significantly lower Hoechst 33342 uptake and greater pimonidazole-adduct formation. There was no difference in oxygen-induced ΔR1 or water diffusivity between the CALR and CALS xenografts. PET revealed significantly higher relative uptake of 18F-FDG in the CALR cohort, which was associated with significantly greater Glut-1 expression. Conclusions: CALR xenografts established from HNSCC cells resistant to EGFR TKIs are more hypoxic, poorly perfused and glycolytic than sensitive CALS tumors. MRI combined with PET can be used to non-invasively assess HNSCC response/resistance to EGFR inhibition.
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Affiliation(s)
- Lauren C. J. Baker
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Arti Sikka
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Jonathan M. Price
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Jessica K. R. Boult
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Elise Y. Lepicard
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Gary Box
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Yann Jamin
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Terry J. Spinks
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Gabriela Kramer-Marek
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Martin O. Leach
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
| | - Suzanne A. Eccles
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Carol Box
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom
| | - Simon P. Robinson
- Division of Radiotherapy & Imaging, The Institute of Cancer Research, London, United Kingdom
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Suzuki H, Tamaki T, Nishio M, Nakata Y, Hanai N, Nishikawa D, Koide Y, Hasegawa Y. Total lesion glycolysis on FDG-PET/CT before salvage surgery predicts survival in laryngeal or pharyngeal cancer. Oncotarget 2018; 9:19115-19122. [PMID: 29721187 PMCID: PMC5922381 DOI: 10.18632/oncotarget.24914] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 03/07/2018] [Indexed: 12/26/2022] Open
Abstract
We investigated whether 18F-fluorodeoxyglucose uptake parameters using positron emission tomography combined with computed tomography predicts several survival outcomes, including lung metastasis-free survival, in patients with laryngeal or pharyngeal cancer who underwent salvage surgery. The maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis were calculated as 18F-fluorodeoxyglucose uptake parameters in 51 patients with laryngeal or pharyngeal cancer before salvage surgery. In univariate analysis, the maximum standardized uptake value ≥ 22.8, metabolic tumor volume ≥ 2.4, and total lesion glycolysis ≥ 5.4 were significantly correlated with shorter overall survival. In multivariate analysis with adjustment for clinical stage, patients with total lesion glycolysis ≥ 5.4 exhibited significantly shorter overall survival. Furthermore, total lesion glycolysis ≥ 5.4 was significantly correlated with shorter disease-specific survival, distant metastasis-free survival, and lung metastasis-free survival in univariate analysis. In conclusion, total lesion glycolysis predicts the survival outcomes including lung metastasis in patients with laryngeal or pharyngeal cancer who underwent salvage surgery.
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Affiliation(s)
- Hidenori Suzuki
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Tsuneo Tamaki
- Department of East Nagoya Positron Emission Tomography Imaging Center, Nagoya, Japan
| | - Masami Nishio
- Department of Radiology, Nagoya Positron Emission Tomography Imaging Center, Nagoya, Japan
| | - Yusuke Nakata
- Department of Otorhinolaryngology, Shiga University of Medical Science, Otsu, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Daisuke Nishikawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yusuke Koide
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
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Pak K, Kim BS, Kim K, Kim IJ, Jun S, Jeong YJ, Shim HK, Kim SD, Cho KS. Prognostic significance of standardized uptake value on F18-FDG PET/CT in patients with extranodal nasal type NK/T cell lymphoma: A multicenter, retrospective analysis. Am J Otolaryngol 2018; 39:1-5. [PMID: 29056243 DOI: 10.1016/j.amjoto.2017.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 10/10/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the value of parameters assessed with F18-flurodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in predicting relapse free survival and overall survival in patients with extranodal nasal type NK/T cell lymphoma. METHODS Thirty-six patients with extranodal nasal type NK/T cell lymphoma, and who underwent PET/CT prior to curative treatment, were enrolled at five institutions. Volumes of interest covering the entire tumor volume were delineated on PET/CT images, and the maximum standardized uptake value (SUVmax), mean SUV (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured using thresholds of 40% of SUVmax. Furthermore, we compared the difference in F18-FDG avidity according to Epstein-Barr virus (EBV) infection status. RESULTS The SUVmax (p=0.041) and SUVmean (p=0.049) in patients who died were higher than the respective values of those who survived. A higher TLG (>45.8) was associated with relapse free survival (HR 7.856, p=0.034). Ann Arbor stage (III-IV, HR 14.12, p=0.004), and a higher SUVmax (>12.6, p=0.024) and SUVmean (>6.4, p=0.024) were associated with poor survival. However, neither the MTV nor the TLG (volumetric parameters) were significant predictors of death. The PET parameters SUVmax (p=0.181), SUVmean (p=0.237), MTV (p=0.636), and TLG (p=0.469) did not differ significantly between patients with and without EBV infections. CONCLUSIONS High TLG was the only significant predictive factor on relapse free survival. The SUVmax and SUVmean measured by F18-FDG PET/CT could be significant prognostic factors in patients with extranodal nasal type NK/T cell lymphoma.
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Affiliation(s)
- Kyoungjune Pak
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Bum Soo Kim
- Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - In Joo Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Sungmin Jun
- Department of Nuclear Medicine, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Young Jin Jeong
- Department of Nuclear Medicine, Dong-A University Medical Center, Busan, Republic of Korea
| | - Hye Kyung Shim
- Department of Nuclear Medicine, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Sung-Dong Kim
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea
| | - Kyu-Sup Cho
- Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, South Korea.
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Bogowicz M, Riesterer O, Stark LS, Studer G, Unkelbach J, Guckenberger M, Tanadini-Lang S. Comparison of PET and CT radiomics for prediction of local tumor control in head and neck squamous cell carcinoma. Acta Oncol 2017; 56:1531-1536. [PMID: 28820287 DOI: 10.1080/0284186x.2017.1346382] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE An association between radiomic features extracted from CT and local tumor control in the head and neck squamous cell carcinoma (HNSCC) has been shown. This study investigated the value of pretreatment functional imaging (18F-FDG PET) radiomics for modeling of local tumor control. MATERIAL AND METHODS Data from HNSCC patients (n = 121) treated with definitive radiochemotherapy were used for model training. In total, 569 radiomic features were extracted from both contrast-enhanced CT and 18F-FDG PET images in the primary tumor region. CT, PET and combined PET/CT radiomic models to assess local tumor control were trained separately. Five feature selection and three classification methods were implemented. The performance of the models was quantified using concordance index (CI) in 5-fold cross validation in the training cohort. The best models, per image modality, were compared and verified in the independent validation cohort (n = 51). The difference in CI was investigated using bootstrapping. Additionally, the observed and radiomics-based estimated probabilities of local tumor control were compared between two risk groups. RESULTS The feature selection using principal component analysis and the classification based on the multivariabale Cox regression with backward selection of the variables resulted in the best models for all image modalities (CICT = 0.72, CIPET = 0.74, CIPET/CT = 0.77). Tumors more homogenous in CT density (decreased GLSZMsize_zone_entropy) and with a focused region of high FDG uptake (higher GLSZMSZLGE) indicated better prognosis. No significant difference in the performance of the models in the validation cohort was observed (CICT = 0.73, CIPET = 0.71, CIPET/CT = 0.73). However, the CT radiomics-based model overestimated the probability of tumor control in the poor prognostic group (predicted = 68%, observed = 56%). CONCLUSIONS Both CT and PET radiomics showed equally good discriminative power for local tumor control modeling in HNSCC. However, CT-based predictions overestimated the local control rate in the poor prognostic validation cohort, and thus, we recommend to base the local control modeling on the 18F-FDG PET.
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Affiliation(s)
- Marta Bogowicz
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Oliver Riesterer
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Luisa Sabrina Stark
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Gabriela Studer
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Jan Unkelbach
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Stephanie Tanadini-Lang
- Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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The application of ultrasound in detecting lymph nodal recurrence in the treated neck of head and neck cancer patients. Sci Rep 2017. [PMID: 28638103 PMCID: PMC5479791 DOI: 10.1038/s41598-017-04039-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Early detection of neck lymph node (LN) recurrence is paramount in improving the prognosis of treated head and neck cancer patients. Ultrasound (US) with US-guided fine needle aspiration (FNA) and core needle biopsy (CNB) have been shown to have great accuracy for LN diagnoses in the untreated neck. However, in the treated neck with fibrosis, their roles are not clarified. Here, we retrospectively review 153 treated head and neck cancer patients who had received US and US-guided FNA/CNB. In multivariate logistic regression analyses, size (short-axis diameter >0.8 cm) (odds ratio (OR) 4.19, P = 0.007), round shape (short/long axis ratio >0.5) (OR 3.44, P = 0.03), heterogeneous internal echo (OR 3.92, P = 0.009) and irregular margin (OR 7.32, P < 0.001) are effective US features in predicting recurrent LNs in the treated neck. However, hypoechogenicity (OR 2.38, P = 0.289) and chaotic/absent vascular pattern (OR 3.04, P = 0.33) are ineffective. US-guided FNA (sensitivity/specificity: 95.24%/97.92%) is effective in the treated neck, though with high non-diagnostic rate (29.69%). US-guided CNB (sensitivity/specificity: 84.62%/100%) is also effective, though with low negative predictive value (62.5%). Overall, US with US-guided FNA/CNB are still effective diagnostic tools for neck nodal recurrence surveillance.
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Hasebe M, Yoshikawa K, Nishii R, Kawaguchi K, Kamada T, Hamada Y. Usefulness of 11C-methionine-PET for predicting the efficacy of carbon ion radiation therapy for head and neck mucosal malignant melanoma. Int J Oral Maxillofac Surg 2017; 46:1220-1228. [PMID: 28535963 DOI: 10.1016/j.ijom.2017.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/08/2017] [Accepted: 04/21/2017] [Indexed: 12/20/2022]
Abstract
The aim of this study was to determine whether l-methyl-[11C]-methionine (MET) positron emission tomography (PET) allows the prediction of outcomes in patients with head and neck mucosal malignant melanoma treated with carbon ion radiation therapy (CIRT). This was a retrospective cohort study involving 85 patients who underwent a MET-PET or MET-PET/computed tomography (CT) examination before and after CIRT. MET uptake in the tumour was evaluated semi-quantitatively using the tumour-to-normal tissue ratio (TNR). Local recurrence, metastasis, and outcome predictions were studied in terms of TNR before CIRT (TNRpre), TNR after CIRT (TNRpost), and the TNR change ratio. Kaplan-Meier curves revealed significant differences between patients with higher TNRpre values and those with lower TNRpre values in regard to local recurrence, metastasis, and outcome (log-rank test P<0.0001 for all three). There were also significant differences in metastasis rates and outcomes between patients with higher and lower TNRpost values (log-rank test P=0.0105 and P=0.027, respectively). The Cox proportional hazards model revealed TNRpre to be a factor significantly influencing the risk of local recurrence (hazard ratio (HR) 29.0, P<0.001), risk of metastasis (HR 2.67, P=0.024), and the outcome (HR 6.3, P<0.001). MET-PET or MET-PET/CT is useful for predicting the outcomes of patients with head and neck mucosal malignant melanoma treated with CIRT.
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Affiliation(s)
- M Hasebe
- Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, Tsurumi, Yokohama, Japan; The Hospital of the National Institute of Radiological Sciences, Chiba, Japan
| | - K Yoshikawa
- The Hospital of the National Institute of Radiological Sciences, Chiba, Japan; Tokyo Bay Advanced Imaging and Radiation Oncology Clinic, Toyosuna, Chiba, Japan.
| | - R Nishii
- The Hospital of the National Institute of Radiological Sciences, Chiba, Japan
| | - K Kawaguchi
- Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, Tsurumi, Yokohama, Japan
| | - T Kamada
- The Hospital of the National Institute of Radiological Sciences, Chiba, Japan
| | - Y Hamada
- Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, Tsurumi, Yokohama, Japan
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Suzuki H, Kato K, Nishio M, Tamaki T, Fujimoto Y, Hiramatsu M, Hanai N, Kodaira T, Itoh Y, Naganawa S, Sone M, Hasegawa Y. FDG-PET/CT predicts survival and lung metastasis of hypopharyngeal cancer in a multi-institutional retrospective study. Ann Nucl Med 2017; 31:514-520. [PMID: 28470631 DOI: 10.1007/s12149-017-1176-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/24/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We investigated a possible correlation between the maximum standardized uptake value (SUVmax), which is assessed by pretreatment 18F-fluorodeoxyglucose positron emission tomography with computed tomography, and the overall survival (OS) in patients with hypopharyngeal squamous cell carcinoma from two institutions on long-term follow-up, and examined whether SUVmax is correlated with several survival outcomes, including lung metastasis-free survival. METHODS A total of 81 patients were enrolled. The survival rate was calculated by the Kaplan-Meier method. Both univariate and multivariate survival analyses were assessed by a Cox proportional hazards model. RESULTS SUVmax ≥15.2 in institution A (p = 0.0306) or SUVmax ≥8 in institution B (p = 0.0132) was significantly predictor of a lower OS. We disaggregated the data by high SUVmax (SUVmax ≥15.2 from institution A and SUVmax ≥8 from institution B) and low SUVmax (SUVmax <15.2 from institution A and SUVmax <8 from institution B). Patients with a high SUVmax exhibited a significantly lower OS in both univariate (p = 0.001) and multivariate (p = 0.0046) analyses for adjusted for the clinical stage and treatment group. The patients with a high SUVmax exhibited significantly shorter disease-specific (p = 0.0068), distant metastasis-free (p = 0.0428), and lung metastasis-free (p = 0.0328) survivals. CONCLUSIONS High SUVmax was significantly correlated with a lower OS, disease-specific survival, distant metastasis-free survival, and lung metastasis-free survival in a multi-institutional retrospective study.
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Affiliation(s)
- Hidenori Suzuki
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
| | - Katsuhiko Kato
- Department of Radiological Technology of Health Sciences, Nagoya University School of Health Sciences, Nagoya, Japan
| | - Masami Nishio
- Department of Radiology, Nagoya Positron Emission Tomography Imaging Center, Nagoya, Japan
| | - Tsuneo Tamaki
- Department of East Nagoya Positron Emission Tomography Imaging Center, Nagoya, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mariko Hiramatsu
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yoshiyuki Itoh
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhisa Hasegawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
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Mena E, Taghipour M, Sheikhbahaei S, Jha AK, Rahmim A, Solnes L, Subramaniam RM. Value of Intratumoral Metabolic Heterogeneity and Quantitative 18F-FDG PET/CT Parameters to Predict Prognosis in Patients With HPV-Positive Primary Oropharyngeal Squamous Cell Carcinoma. Clin Nucl Med 2017; 42:e227-e234. [PMID: 28195905 PMCID: PMC5380578 DOI: 10.1097/rlu.0000000000001578] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the impact of intratumoral metabolic heterogeneity and quantitative FDG PET/CT imaging parameters for predicting patient outcomes in primary oropharyngeal squamous cell cancer (OPSCC). PATIENTS AND METHODS We retrospectively investigated 105 patients with HPV-positive OPSCC. SUVmax and metabolic tumor volume (MTV) were measured for the primary tumors and when available for the metastatic sites. Primary tumor intratumoral metabolic heterogeneity was calculated as the area under a cumulative SUV volume histograms curve (AUC-CSH). The median follow-up time was 35.4 months (range, 3-92 months). Outcome end point was event-free survival (EFS). Kaplan-Meier survival plots and Cox regression analyses were performed. RESULTS Of the 105 patients included, 19 patients relapsed and 11 deceased during the study period. AUC-CSH indexes were associated with EFS using PET gradient-based (P = 0.034) and 50% threshold (P = 0.02) segmentation methods, on multivariate analysis. Kaplan-Meier survival analysis using optimum cutoff of 16.7 SUVmax and 12.7 mL total MTV were significant predictors of EFS. Combining SUVmax and AUC-CSH index in 3 subgroups, patients with higher intratumoral heterogeneity and higher SUVmax were associated with worse outcome (log-rank, P = 0.026). Similarly, patients with higher intratumoral heterogeneity tumors and higher MTV had worse prognosis (log-rank, P = 0.022). CONCLUSIONS Intratumoral metabolic heterogeneity using FDG PET was a prognostic factor for EFS in patients with primary HPV (+) OPSCC. The combined predictive effect of FDG avidity, metabolic tumor burden, and intratumoral heterogeneity provided prognostic survival information in these patients.
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Affiliation(s)
- Esther Mena
- From the *Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Baltimore, MD; †Department of Radiology, ‡Department Clinical Sciences, §Advanced Imaging Research Center, and ∥Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX
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Huang Y, Feng M, He Q, Yin J, Xu P, Jiang Q, Lang J. Prognostic value of pretreatment 18F-FDG PET-CT for nasopharyngeal carcinoma patients. Medicine (Baltimore) 2017; 96:e6721. [PMID: 28445287 PMCID: PMC5413252 DOI: 10.1097/md.0000000000006721] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) is a special subtype of head and neck cancer (HNC). At present, there are no highly specific prognostic markers to aid in tumor grading and guide patient treatment modalities for NPC. The prognostic value of pretreatment F-fluorodeoxyglucose positron emission tomography-computed tomography (F-PET-CT) in NPC patients is controversial and no consensus exists as to its predictive capability. METHODS To analyze the predictive efficacy of F-PET-CT imaging in NPC patients, data from MEDLINE, EMBASE, the Cochrane library, CBM, CNKI, and VIP (inception to July 2016) were accessed. Results from prospective and retrospective observational studies that used F-FDG PET to predict disease prognosis in NPC patients were used for analysis. Two authors independently assessed study quality and extracted data. Event-free survival (EFS) was considered the primary endpoint and overall survival rate (OS) was considered the secondary endpoint. RESULTS Data from 14 studies and 1134 patients were included in our analysis. The hazard ratios (HRs) of maximum standardized uptake value of primary tumor (SUVmax-T), metabolic tumor volume of primary tumor (MTV-T), and total lesional glycolysis of primary tumor (TLG-T) for EFS were 1.31 (95% confidence interval [CI], 1.11-1.55, P = .001), 2.38 (95% CI 1.53-3.70, P < .001), and 1.65 (95% CI 0.76-3.59, P = .21), respectively. Among studies including TLG-T, those with a fixed SUV of 2.5 had an HR of 3.55 (95% CI, 1.42-8.84, P = .007). The HRs of SUVmax-T and MTV-T for OS were 2.19 (95% CI, 1.47-3.27, P < .001) and 2.69 (95% CI, 1.01-7.17, P = .05), respectively. Among studies including MTV-T, those with a fixed SUV of 2.5 had an HR of 4.07 (95% CI, 2.22-7.46, P < .001). Tests used for assessing predictive value of pretreatment SUVmax, MTV, and TLG of lymph nodes for EFS and OS showed that these parameters did not have significant predictive value (P>.05). CONCLUSION Our results suggested that SUVmax, MTV, and TLG (with a fixed SUV of 2.5) of primary tumors before treatment initiation may be independent prognostic factors for NPC patients; however, SUVmax, MTV, and TLG of metastatic lymph nodes are not.
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Affiliation(s)
| | - Mei Feng
- Department of Radiation Oncology
| | - Qiao He
- Department of Clinical Laboratory, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine,University of Electronic Science and Technology of China, Chengdu, PR China
| | - Jun Yin
- Department of Radiation Oncology
| | - Peng Xu
- Department of Radiation Oncology
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Abstract
Glycolysis is highly upregulated in head and neck squamous cell carcinoma (HNSCC). HNSCC glycolysis is an important contributor to disease progression and decreases sensitivity to radiation or chemotherapy. Despite therapeutic advances, the survival rates for HNSCC patients remain low. Understanding glycolysis regulation in HNSCC will facilitate the development of effective therapeutic strategies for this disease. In this review, we will evaluate the regulation of altered HNSCC glycolysis and possible therapeutic approaches by targeting glycolytic pathways.
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Affiliation(s)
- Dhruv Kumar
- Department of Bioinformatics, SRM University, Sonepat, Haryana-131029, India
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Mena E, Thippsandra S, Yanamadala A, Redy S, Pattanayak P, Subramaniam RM. Molecular Imaging and Precision Medicine in Head and Neck Cancer. PET Clin 2016; 12:7-25. [PMID: 27863568 DOI: 10.1016/j.cpet.2016.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The concept of using tumor genomic profiling information has revolutionized personalized cancer treatment. Head and neck (HN) cancer management is being influenced by recent discoveries of activating mutations in epidermal growth factor receptor and related targeted therapies with tyrosine kinase inhibitors, targeted therapies for Kristen Rat Sarcoma, and MET proto-oncogenes. Molecular imaging using PET plays an important role in assessing the biologic behavior of HN cancer with the goal of delivering individualized cancer treatment. This review summarizes recent genomic discoveries in HN cancer and their implications for functional PET imaging in assessing response to targeted therapies, and drug resistance mechanisms.
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Affiliation(s)
- Esther Mena
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Shwetha Thippsandra
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Anusha Yanamadala
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Siddaling Redy
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Puskar Pattanayak
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA
| | - Rathan M Subramaniam
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Johns Hopkins University, 601 North Caroline Street, Baltimore, MD 21287, USA; Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8896, USA; Department of Clinical Sciences, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9096, USA; Department of Biomedical Engineering, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-8896, USA; Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390-8896, USA.
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50
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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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