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Nashi IT, Morsy HA, Shalaby MH, Ali SA. Role of 18F-FDG PET/CT in assessment of HCC patients after therapeutic interventions compared to DW MRI. Egypt J Radiol Nucl Med 2022. [DOI: 10.1186/s43055-022-00867-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide in both men and women. Early-stage HCCs are treated either by curative surgical resection and/or by locoregional interventions, such as radiofrequency ablation or trans-arterial chemoembolization. Functional imaging as diffusion-weighted magnetic resonance imaging (DW MRI) and metabolic imaging with 18F-positron emission tomography/computed tomography (18F-FDG PET/CT) has been used for assessment of treatment response. This retrospective study was conducted on 29 patients known to have HCC with locoregional therapeutic interventions and referred for radiological follow-up searching for residual/recurrence neoplasia or metastatic deposits. The study aimed to assess the benefits of using the metabolic parameters of 18F-FDG PET/CT in the follow-up of HCC patients after therapeutic interventions in comparison with DW MRI.
Results
Regarding qualitative assessment of residual active viable HCC by PET/CT and DW MRI, the sensitivity, specificity, PPV, NPP and accuracy were 77.3%, 91.7%, 94.4%, 68.8%, 82.4% and 95.5%, 75%, 87.5%, 90%, 88.2%, respectively. The optimal cutoff point of the SUVmax to differentiate viable from non-viable HCC was 3.4 (AUC = 0.898), with sensitivity, specificity, PPV and NPV of 77.27%, 100.0%, 100.0% and 66.7%, respectively. The optimal ADC cutoff value for discrimination between viable and non-viable HCC was 1247 mm2/s (AUC = 0.976) with sensitivity, specificity, PPV and NPV of 90.48%, 100.0%, 100.0% and 83.3%, respectively. New hepatic lesions were found in 38.2% of patients by DW MRI, while detected only in 26.5% of patients by PET/CT. The PET/CT revealed extrahepatic metastasis in 44.1% of patients, while detected only in 8.8% of patients by DW MRI.
Conclusions
DWI was more sensitive than PET/CT for detecting tumor residual and hepatic recurrence compared to PET/CT which was much better in detecting distant metastases.
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Oldan JD, Beaty BM, Jewells VL, Muhleman MA, Benefield T, Chera B. Qualitative and quantitative methods in post-chemoradiation PET for head and neck cancer. Nucl Med Commun 2022; 43:710-716. [PMID: 35414636 DOI: 10.1097/mnm.0000000000001558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether quantitative methods could aid in the evaluation of post-treatment head and neck scans, particularly taking human papillomavirus status into account. METHODS Clinical readings of positron emission tomography/computed tomography scans as well as standardized uptake value (SUV)max (and other metrics) of nodes visible on PET conducted on a total of 172 patients with head and neck squamous cell cancer were examined. Locoregional recurrence at 2 years was assessed. In total 88 of these patients had close enough follow-up to determine whether individual nodes were positive or negative, and 233 nodes on these patients were compared to surgical pathology notes or follow-up (if no path was available). RESULTS General negative predictive value (NPV) of complete response was 93% and an equivocal response was 89%; focusing on nodal recurrence, NPV was found to be 97% and positive predictive value (PPV) 46% if equivocal reads were treated as negative and NPV 98% and PPV 16% if equivocal reads were treated as positive. Using SUVmax of the hottest node with a cutoff of 3.4 gave NPV 97% and PPV 26%; a direct re-read (using 2 observers) gave NPV 98% and PPV 32% if equivocal reads were treated as negative, and NPV 99% and PPV 18% if equivocal reads were treated as positive. Using other first-order radiomics data such as SD and skewness did not improve this. CONCLUSIONS Quantitative data such as SUVmax does not show additional value over qualitative evaluation of response to chemoradiation in head and neck tumors.
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Affiliation(s)
| | - Brian M Beaty
- Department of Radiation Oncology, University of North Carolina-Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, USA
| | | | | | | | - Bhishamjit Chera
- Department of Radiation Oncology, University of North Carolina-Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514, USA
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Freihat O, Zoltán T, Pinter T, Kedves A, Sipos D, Repa I, Kovács Á, Zsolt C. Correlation between Tissue Cellularity and Metabolism Represented by Diffusion-Weighted Imaging (DWI) and 18F-FDG PET/MRI in Head and Neck Cancer (HNC). Cancers (Basel) 2022; 14:cancers14030847. [PMID: 35159115 PMCID: PMC8833888 DOI: 10.3390/cancers14030847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 01/02/2023] Open
Abstract
Simple Summary We report on the correlation between the diffusion-weighted imaging (DWI) and the metabolic volume parameters derived from a PET scan, to determine the correlation between these parameters and the tumor cellularity in head and neck primary tumors. Our findings implied that there was no correlation between the information derived from the DWI and the information derived from the FDG metabolic parameters. Thus, both imaging techniques might play a complementary role in HNC diagnosis and assessment. This is significant because the treatment plan of patients with HNC should be well evaluated by using all the available diagnosis techniques, for a better understanding of how the tumor will react. Abstract Background: This study aimed to assess the association of 18F-Fluorodeoxyglucose positron-emission-tomography (18F-FDG/PET) and DWI imaging parameters from a primary tumor and their correlations with clinicopathological factors. Methods: We retrospectively analyzed primary tumors in 71 patients with proven HNC. Primary tumor radiological parameters: DWI and FDG, as well as pathological characteristics were analyzed. Spearman correlation coefficient was used to assess the correlation between DWI and FDG parameters, ANOVA or Kruskal–Wallis, independent sample t-test, Mann–Whitney test, and multiple regression were performed on the clinicopathological features that may affect the 18F- FDG and apparent-diffusion coefficient (ADC) of the tumor. Results: No significant correlations were observed between DWI and any of the 18F-FDG parameters (p > 0.05). SUVmax correlated with N-stages (p = 0.023), TLG and MTV correlated with T-stages (p = 0.006 and p = 0.001), and ADC correlated with tumor grades (p = 0.05). SUVmax was able to differentiate between N+ and N− groups (p = 0.004). Conclusions: Our results revealed a non-significant correlation between the FDG-PET and ADC-MR parameters. FDG-PET-based glucose metabolic and DWI-MR-derived cellularity data may represent different biological aspects of HNC.
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Affiliation(s)
- Omar Freihat
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
- Correspondence: (O.F.); (Á.K.); Tel.: +36-52-411-600 (Á.K.)
| | - Tóth Zoltán
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- MEDICOPUS Healthcare Provider and Public Nonprofit Ltd., Somogy County Moritz Kaposi Teaching Hospital, 7400 Kaposvár, Hungary
| | - Tamas Pinter
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
| | - András Kedves
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
- Institute of Information Technology and Electrical Technology, Faculty of Engineering and Information Technology, University of Pécs, 7621 Pécs, Hungary
| | - Dávid Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
| | - Imre Repa
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, 7400 Kaposvár, Hungary;
| | - Árpád Kovács
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Department of Oncoradiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
- Correspondence: (O.F.); (Á.K.); Tel.: +36-52-411-600 (Á.K.)
| | - Cselik Zsolt
- Doctoral School of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (T.Z.); (A.K.); (I.R.); (C.Z.)
- Csolnoky Ferenc County Hospital, 8200 Veszprém, Hungary
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Paudyal R, Grkovski M, Oh JH, Schöder H, Nunez DA, Hatzoglou V, Deasy JO, Humm JL, Lee NY, Shukla-Dave A. Application of Community Detection Algorithm to Investigate the Correlation between Imaging Biomarkers of Tumor Metabolism, Hypoxia, Cellularity, and Perfusion for Precision Radiotherapy in Head and Neck Squamous Cell Carcinomas. Cancers (Basel) 2021; 13:3908. [PMID: 34359810 PMCID: PMC8345739 DOI: 10.3390/cancers13153908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 11/17/2022] Open
Abstract
The present study aimed to investigate the correlation at pre-treatment (TX) between quantitative metrics derived from multimodality imaging (MMI), including 18F-FDG-PET/CT, 18F-FMISO-PET/CT, DW- and DCE-MRI, using a community detection algorithm (CDA) in head and neck squamous cell carcinoma (HNSCC) patients. Twenty-three HNSCC patients with 27 metastatic lymph nodes underwent a total of 69 MMI exams at pre-TX. Correlations among quantitative metrics derived from FDG-PET/CT (SUL), FMSIO-PET/CT (K1, k3, TBR, and DV), DW-MRI (ADC, IVIM [D, D*, and f]), and FXR DCE-MRI [Ktrans, ve, and τi]) were investigated using the CDA based on a "spin-glass model" coupled with the Spearman's rank, ρ, analysis. Mean MRI T2 weighted tumor volumes and SULmean values were moderately positively correlated (ρ = 0.48, p = 0.01). ADC and D exhibited a moderate negative correlation with SULmean (ρ ≤ -0.42, p < 0.03 for both). K1 and Ktrans were positively correlated (ρ = 0.48, p = 0.01). In contrast, Ktrans and k3max were negatively correlated (ρ = -0.41, p = 0.03). CDA revealed four communities for 16 metrics interconnected with 33 edges in the network. DV, Ktrans, and K1 had 8, 7, and 6 edges in the network, respectively. After validation in a larger population, the CDA approach may aid in identifying useful biomarkers for developing individual patient care in HNSCC.
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Affiliation(s)
- Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (M.G.); (J.H.O.); (D.A.N.); (J.O.D.); (J.L.H.)
| | - Milan Grkovski
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (M.G.); (J.H.O.); (D.A.N.); (J.O.D.); (J.L.H.)
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (M.G.); (J.H.O.); (D.A.N.); (J.O.D.); (J.L.H.)
| | - Heiko Schöder
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (H.S.); (V.H.)
| | - David Aramburu Nunez
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (M.G.); (J.H.O.); (D.A.N.); (J.O.D.); (J.L.H.)
| | - Vaios Hatzoglou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (H.S.); (V.H.)
| | - Joseph O. Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (M.G.); (J.H.O.); (D.A.N.); (J.O.D.); (J.L.H.)
| | - John L. Humm
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (M.G.); (J.H.O.); (D.A.N.); (J.O.D.); (J.L.H.)
| | - Nancy Y. Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (M.G.); (J.H.O.); (D.A.N.); (J.O.D.); (J.L.H.)
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (H.S.); (V.H.)
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Paudyal R, Chen L, Oh JH, Zakeri K, Hatzoglou V, Tsai CJ, Lee N, Shukla-Dave A. Nongaussian Intravoxel Incoherent Motion Diffusion Weighted and Fast Exchange Regime Dynamic Contrast-Enhanced-MRI of Nasopharyngeal Carcinoma: Preliminary Study for Predicting Locoregional Failure. Cancers (Basel) 2021; 13:cancers13051128. [PMID: 33800762 PMCID: PMC7961986 DOI: 10.3390/cancers13051128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 12/28/2022] Open
Abstract
Simple Summary Pre-treatment (TX) prediction of the risk of locoregional failure (LRF) will allow for TX individualization in patients with nasopharyngeal carcinoma (NPC). The aim of the present study was to identify whether the quantitative metrics from pre-TX non-Gaussian intravoxel incoherent motion (NGIVIM) diffusion weighted (DW-) and fast exchange regime (FXR) dynamic contrast enhanced can predict patients with LRF in NPC. Cumulative incidence (CI) analysis and Fine-Gray (FG) proportional subhazards modeling were conducted in a sample of 29 NPC patients considering death as a competing risk. NGIVIM and FXR derived quantitative metric values from primary tumors classified the patients with and without LRF in NPC. The CI analysis and FG modeling results suggest that the quantitative metrics obtained from DW- and DCE-MRI may improve LRF patients’ prediction in NPC. Abstract The aim of the present study was to identify whether the quantitative metrics from pre-treatment (TX) non-Gaussian intravoxel incoherent motion (NGIVIM) diffusion weighted (DW-) and fast exchange regime (FXR) dynamic contrast enhanced (DCE)-MRI can predict patients with locoregional failure (LRF) in nasopharyngeal carcinoma (NPC). Twenty-nine NPC patients underwent pre-TX DW- and DCE-MRI on a 3T MR scanner. DW imaging data from primary tumors were fitted to monoexponential (ADC) and NGIVIM (D, D*, f, and K) models. The metrics Ktrans, ve, and τi were estimated using the FXR model. Cumulative incidence (CI) analysis and Fine-Gray (FG) modeling were performed considering death as a competing risk. Mean ve values were significantly different between patients with and without LRF (p = 0.03). Mean f values showed a trend towards the difference between the groups (p = 0.08). Histograms exhibited inter primary tumor heterogeneity. The CI curves showed significant differences for the dichotomized cutoff value of ADC ≤ 0.68 × 10−3 (mm2/s), D ≤ 0.74 × 10−3 (mm2/s), and f ≤ 0.18 (p < 0.05). τi ≤ 0.89 (s) cutoff value showed borderline significance (p = 0.098). FG’s modeling showed a significant difference for the K cutoff value of ≤0.86 (p = 0.034). Results suggest that the role of pre-TX NGIVIM DW- and FXR DCE-MRI-derived metrics for predicting LRF in NPC than alone.
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Affiliation(s)
- Ramesh Paudyal
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (J.H.O.)
| | - Linda Chen
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (L.C.); (K.Z.); (C.J.T.); (N.L.)
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (J.H.O.)
| | - Kaveh Zakeri
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (L.C.); (K.Z.); (C.J.T.); (N.L.)
| | - Vaios Hatzoglou
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
| | - C. Jillian Tsai
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (L.C.); (K.Z.); (C.J.T.); (N.L.)
| | - Nancy Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (L.C.); (K.Z.); (C.J.T.); (N.L.)
| | - Amita Shukla-Dave
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; (R.P.); (J.H.O.)
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA;
- Correspondence: ; Tel.: +1-212-639-3184
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Chung SR, Choi YJ, Suh CH, Lee JH, Baek JH. Diffusion-weighted Magnetic Resonance Imaging for Predicting Response to Chemoradiation Therapy for Head and Neck Squamous Cell Carcinoma: A Systematic Review. Korean J Radiol 2020; 20:649-661. [PMID: 30887747 PMCID: PMC6424826 DOI: 10.3348/kjr.2018.0446] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/11/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To systematically review the evaluation of the diagnostic accuracy of pre-treatment apparent diffusion coefficient (ADC) and change in ADC during the intra- or post-treatment period, for the prediction of locoregional failure in patients with head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS Ovid-MEDLINE and Embase databases were searched up to September 8, 2018, for studies on the use of diffusion-weighted magnetic resonance imaging for the prediction of locoregional treatment response in patients with HNSCC treated with chemoradiation or radiation therapy. Risk of bias was assessed by using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. RESULTS Twelve studies were included in the systematic review, and diagnostic accuracy assessment was performed using seven studies. High pre-treatment ADC showed inconsistent results with the tendency for locoregional failure, whereas all studies evaluating changes in ADC showed consistent results of a lower rise in ADC in patients with locoregional failure compared to those with locoregional control. The sensitivities and specificities of pre-treatment ADC and change in ADC for predicting locoregional failure were relatively high (range: 50-100% and 79-96%, 75-100% and 69-95%, respectively). Meta-analytic pooling was not performed due to the apparent heterogeneity in these values. CONCLUSION High pre-treatment ADC and low rise in early intra-treatment or post-treatment ADC with chemoradiation, could be indicators of locoregional failure in patients with HNSCC. However, as the studies are few, heterogeneous, and at high risk for bias, the sensitivity and specificity of these parameters for predicting the treatment response are yet to be determined.
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Affiliation(s)
- Sae Rom Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.,Department of Radiology, Namwon Medical Center, Namwon, Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Vidiri A, Marzi S, Gangemi E, Benevolo M, Rollo F, Farneti A, Marucci L, Spasiano F, Sperati F, Di Giuliano F, Pellini R, Sanguineti G. Intravoxel incoherent motion diffusion-weighted imaging for oropharyngeal squamous cell carcinoma: Correlation with human papillomavirus Status. Eur J Radiol 2019; 119:108640. [DOI: 10.1016/j.ejrad.2019.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/17/2019] [Accepted: 08/11/2019] [Indexed: 01/04/2023]
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8
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Payabvash S, Chan A, Jabehdar Maralani P, Malhotra A. Quantitative diffusion magnetic resonance imaging for prediction of human papillomavirus status in head and neck squamous-cell carcinoma: A systematic review and meta-analysis. Neuroradiol J 2019; 32:232-240. [PMID: 31084347 DOI: 10.1177/1971400919849808] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Head and neck squamous-cell carcinoma (HNSCC) related to human papillomavirus (HPV) infection represents a distinct biological and prognostic subtype compared to the HPV-negative form. Prior studies suggest a correlation between the apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI) of primary tumor lesion and HPV status in HNSCC. In this meta-analysis, we compared the average ADC of primary lesion between HPV-positive and HPV-negative HNSCC. METHODS A comprehensive literature search of PubMed and Embase was performed. Studies comparing the average ADC on echo-planar DWI of primary tumor lesions between HPV-positive and HPV-negative HNSCC were included. The standardized mean difference was calculated using fixed- and random-effects models. Tau-squared estimates of total heterogeneity and Higgins inconsistency index (I2 test) were determined. RESULTS A total of five studies, pooling data of 264 patients, were included for meta-analysis. Among these five studies, three had included oral cavity, hypopharyngeal, and/or laryngeal HNSCC in addition to oropharyngeal subsite. Primary lesions were comprised of 185 HPV-negative and 79 HPV-positive HNSCC. The meta-analysis showed lower average ADC values in HPV-positive HNSCC compared to the HPV-negative form, with a standardized mean difference of 0.961 (95% confidence interval 0.644-1.279; p < 0.0001). Since there was no significant heterogeneity in analysis (p = 0.3852), both random- and fixed-effects models resulted in the same estimates of overall effect. CONCLUSIONS HPV-positive HNSCC primary lesions have a lower average ADC compared to the HPV-negative form, highlighting the potential application of quantitative diffusion magnetic resonance imaging as a noninvasive imaging biomarker for prediction of HPV status.
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Affiliation(s)
| | - Aimee Chan
- 2 Department of Medical Imaging, University of Toronto, Canada
| | | | - Ajay Malhotra
- 1 Department of Radiology and Biomedical Imaging, Yale School of Medicine, USA
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Zwirner K, Thorwarth D, Winter RM, Welz S, Weiss J, Schwenzer NF, Schmidt H, la Fougère C, Nikolaou K, Zips D, Gatidis S. Voxel-wise correlation of functional imaging parameters in HNSCC patients receiving PET/MRI in an irradiation setup. Strahlenther Onkol 2018; 194:719-726. [PMID: 29564483 DOI: 10.1007/s00066-018-1292-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/05/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE The purpose of this study was to demonstrate the feasibility of voxel-wise multiparametric characterization of head and neck squamous cell carcinomas (HNSCC) using hybrid multiparametric magnetic resonance imaging and positron emission tomography with [18F]-fluorodesoxyglucose (FDG-PET/MRI) in a radiation treatment planning setup. METHODS Ten patients with locally advanced HNSCC were examined with a combined FDG-PET/MRI in an irradiation planning setup. The multiparametric imaging protocol consisted of FDG-PET, T2-weighted transverse short tau inversion recovery sequence (STIR) and diffusion-weighted MRI (DWI). Primary tumours were manually segmented and quantitative imaging parameters were extracted. PET standardized uptake values (SUV) and DWI apparent diffusion coefficients (ADC) were correlated on a voxel-wise level. RESULTS Images acquired in this specialised radiotherapy planning setup achieved good diagnostic quality. Median tumour volume was 4.9 [1.1-42.1] ml. Mean PET SUV and ADC of the primary tumours were 5 ± 2.5 and 1.2 ± 0.3 10-3 mm2/s, respectively. In voxel-wise correlation between ADC values and corresponding FDG SUV of the tumours, a significant negative correlation was observed (r = -0.31 ± 0.27, p < 0.05). CONCLUSION Multiparametric voxel-wise characterization of HNSCC is feasible using combined PET/MRI in a radiation planning setup. This technique may provide novel insights into tumour biology with regard to radiation therapy in the future.
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Affiliation(s)
- Kerstin Zwirner
- Department of Radiation Oncology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - Daniela Thorwarth
- Section for Biomedical Physics, Department of Radiation Oncology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,German Cancer Research Center (DKFZ) partner site Tübingen, German Cancer Consortium (DKTK), Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - René M Winter
- Section for Biomedical Physics, Department of Radiation Oncology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Stefan Welz
- Department of Radiation Oncology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,German Cancer Research Center (DKFZ) partner site Tübingen, German Cancer Consortium (DKTK), Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Jakob Weiss
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Nina F Schwenzer
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Holger Schmidt
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Christian la Fougère
- German Cancer Research Center (DKFZ) partner site Tübingen, German Cancer Consortium (DKTK), Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,Division of Nuclear Medicine and Clinical Molecular Imaging, Department of Radiology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Otfried-Müller-Straße 14, 72076, Tübingen, Germany
| | - Konstantin Nikolaou
- German Cancer Research Center (DKFZ) partner site Tübingen, German Cancer Consortium (DKTK), Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Daniel Zips
- Department of Radiation Oncology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.,German Cancer Research Center (DKFZ) partner site Tübingen, German Cancer Consortium (DKTK), Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Sergios Gatidis
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
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Zeinali-Rafsanjani B, Faghihi R, Mosleh-Shirazi MA, Saeedi-Moghadam M, Jalli R, Sina S. Effect of age-dependent bone electron density on the calculated dose distribution from kilovoltage and megavoltage photon and electron radiotherapy in paediatric MRI-only treatment planning. Br J Radiol 2018; 91:20170511. [PMID: 29091480 PMCID: PMC5966214 DOI: 10.1259/bjr.20170511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 10/17/2017] [Accepted: 10/26/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE MRI-only treatment planning (TP) can be advantageous in paediatric radiotherapy. However, electron density extraction is necessary for dose calculation. Normally, after bone segmentation, a bulk density is assigned. However, the variation of bone bulk density in patients makes the creation of pseudo CTs challenging. This study aims to assess the effects of bone density variations in children on radiation attenuation and dose calculation for MRI-only TP. METHODS Bone contents of <15-year-old children were calculated, and substituted in the Oak Ridge National Laboratory paediatric phantoms. The percentage depth dose and beam profile of 150 kVp and 6 MV photon and 6 MeV electron beams were then calculated using Xcom, MCNPX (Monte Carlo N-particle version X) and ORLN phantoms. RESULTS Using 150 kVp X-rays, the difference in attenuation coefficient was almost 5% between an 11-year-old child and a newborn, and ~8% between an adult and a newborn. With megavoltage radiation, the differences were smaller but still important. For an 18 MV photon beam, the difference of radiation attenuation between an 11-year-old child and a newborn was 4% and ~7.4% between an adult and a newborn. For 6 MeV electrons, dose differences were observed up to the 2 cm depth. The percentage depth dose difference between 1 and 10-year-olds was 18.5%, and between 10 and 15-year-olds was 24%. CONCLUSION The results suggest that for MRI-only TP of photon- or electron-beam radiotherapy, the bone densities of each age group should be defined separately for accurate dose calculation. Advances in knowledge: This study highlights the need for more age-specific determination of bone electron density for accurate dose calculations in paediatric MRI-only radiotherapy TP.
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Affiliation(s)
- B Zeinali-Rafsanjani
- Department of Nuclear Engineering, School of Mechanical Engineering, Shiraz University, Shiraz, Iran
| | | | | | - M Saeedi-Moghadam
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - R Jalli
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Sina
- Radiation Research Center, School of Mechanical Engineering, Shiraz University, Shiraz, Iran
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