Changes in multimodality functional imaging parameters early during chemoradiation predict treatment response in patients with locally advanced head and neck cancer
Creators
- 1. The Institute of Cancer Research, Radiotherapy and Imaging Division, London (United Kingdom)
- 2. The Royal Marsden NHS Foundation Trust, Head and Neck Unit, Sutton (United Kingdom)
- 3. The Royal Marsden NHS Foundation Trust, Clinical Radiology, Sutton (United Kingdom)
- 4. The Royal Marsden NHS Foundation Trust, Nuclear Medicine, Sutton (United Kingdom)
- 5. The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, CRUK Cancer Imaging Centre, London (United Kingdom)
Description
To assess the optimal timing and predictive value of early intra-treatment changes in multimodality functional and molecular imaging (FMI) parameters as biomarkers for clinical remission in patients receiving chemoradiation for head and neck squamous cell carcinoma (HNSCC). Thirty-five patients with stage III-IVb (AJCC 7th edition) HNSCC prospectively underwent 18F-FDG-PET/CT, and diffusion-weighted (DW), dynamic contrast-enhanced (DCE) and susceptibility-weighted MRI at baseline, week 1 and week 2 of chemoradiation. Patients with evidence of persistent or recurrent disease during follow-up were classed as non-responders. Changes in FMI parameters at week 1 and week 2 were compared between responders and non-responders with the Mann-Whitney U test. The significance threshold was set at a p value of <0.05. There were 27 responders and 8 non-responders. Responders showed a greater reduction in PET-derived tumor total lesion glycolysis (TLG40%; p = 0.007) and maximum standardized uptake value (SUVmax; p = 0.034) after week 1 than non-responders but these differences were absent by week 2. In contrast, it was not until week 2 that MRI-derived parameters were able to discriminate between the two groups: larger fractional increases in primary tumor apparent diffusion coefficient (ADC; p < 0.001), volume transfer constant (Ktrans; p = 0.012) and interstitial space volume fraction (Ve; p = 0.047) were observed in responders versus non-responders. ADC was the most powerful predictor (∇ >17%, AUC 0.937). Early intra-treatment changes in FDG-PET, DW and DCE MRI-derived parameters are predictive of ultimate response to chemoradiation in HNSCC. However, the optimal timing for assessment with FDG-PET parameters (week 1) differed from MRI parameters (week 2). This highlighted the importance of scanning time points for the design of FMI risk-stratified interventional studies. (orig.)
Availability note (English)
Available from: http://dx.doi.org/10.1007/s00259-017-3890-2Additional details
Identifiers
Publishing Information
- Journal Title
- European Journal of Nuclear Medicine and Molecular Imaging
- Journal Volume
- 45
- Journal Issue
- 5
- Journal Page Range
- p. 759-767
- ISSN
- 1619-7070
- CODEN
- EJNMA6
INIS
- Country of Publication
- Germany
- Country of Input or Organization
- Germany
- INIS RN
- 49054372
- Subject category
- S62: RADIOLOGY AND NUCLEAR MEDICINE;
- Descriptors DEI
- BIOLOGICAL MARKERS; CARCINOMAS; CHEMOTHERAPY; COMBINED THERAPY; COMPUTERIZED TOMOGRAPHY; FLUORINE 18; FLUORODEOXYGLUCOSE; HEAD; IMAGE PROCESSING; MAGNETIC SUSCEPTIBILITY; NECK; NMR IMAGING; POSITRON COMPUTED TOMOGRAPHY; RADIOPHARMACEUTICALS; RADIOTHERAPY; RELAXATION TIME; SPIN ECHO; UPTAKE; WEIGHTING FUNCTIONS
- Descriptors DEC
- ANTIMETABOLITES; BETA DECAY RADIOISOTOPES; BETA-PLUS DECAY RADIOISOTOPES; BODY; COMPUTERIZED TOMOGRAPHY; DIAGNOSTIC TECHNIQUES; DISEASES; DRUGS; EMISSION COMPUTED TOMOGRAPHY; FLUORINE ISOTOPES; FUNCTIONS; HOURS LIVING RADIOISOTOPES; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; LABELLED COMPOUNDS; LIGHT NUCLEI; MAGNETIC PROPERTIES; MATERIALS; MEDICINE; NANOSECONDS LIVING RADIOISOTOPES; NEOPLASMS; NUCLEAR MEDICINE; NUCLEI; ODD-ODD NUCLEI; PHYSICAL PROPERTIES; PROCESSING; RADIOACTIVE MATERIALS; RADIOISOTOPES; RADIOLOGY; THERAPY; TOMOGRAPHY