Increased evidence for the prognostic value of primary tumor asphericity in pretherapeutic FDG PET for risk stratification in patients with head and neck cancer

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• 作者：Frank Hofheinz (1)
  Alexandr Lougovski (1)
  Klaus Z枚phel (2)
  Maria Hentschel (2)
  Ingo G. Steffen (3)
  Ivayla Apostolova (4)
  Florian Wedel (3)
  Ralph Buchert (3)
  Michael Baumann (5) (6) (7)
  Winfried Brenner (3)
  J枚rg Kotzerke (1) (2)
  J枚rg van den Hoff (1) (2)
  
  1. PET Center ; Institute of Radiopharmaceutical Cancer Research ; Helmholtz-Zentrum Dresden-Rossendorf ; Bautzner Landstrasse 400 ; 01328 ; Dresden ; Germany
  2. Department of Nuclear Medicine ; University Hospital Carl Gustav Carus ; Technische Universit盲t Dresden ; Dresden ; Germany
  3. Department of Nuclear Medicine ; Charit茅 - Universit盲tsmedizin Berlin ; Berlin ; Germany
  4. Klinik f眉r Radiologie und Nuklearmedizin ; Universit盲tsklinikum Magdeburg A.枚.R. ; Magdeburg ; Germany
  5. Department of Radiation Oncology ; University Hospital Carl Gustav Carus ; Technische Universit盲t Dresden ; Dresden ; Germany
  6. OncoRay - National Center for Radiation Research in Oncology ; Dresden ; Germany
  7. Institute of Radiooncology ; Helmholtz-Zentrum Dresden-Rossendorf ; Dresden ; Germany
  
• 关键词：PET ; FDG ; Head and neck cancer ; Tumor heterogeneity ; Asphericity ; Prognostic value
• 刊名：European Journal of Nuclear Medicine and Molecular Imaging
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：42
• 期：3
• 页码：429-437
• 全文大小：514 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Nuclear Medicine
  Imaging and Radiology
  Orthopedics
  Cardiology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1619-7089

文摘

Purpose In a previous study, we demonstrated the first evidence that the asphericity (ASP) of pretherapeutic FDG uptake in the primary tumor provides independent prognostic information in patients with head and neck cancer. The aim of this work was to confirm these results in an independent patient group examined at a different site. Methods FDG-PET/CT was performed in 37 patients. The primary tumor was delineated by an automatic algorithm based on adaptive thresholding. For the resulting ROIs, the metabolically active part of the tumor (MTV), SUVmax, SUVmean, total lesion glycolysis (TLG) and ASP were computed. Univariate Cox regression with respect to progression free survival (PFS) and overall survival (OS) was performed. For survival analysis, patients were divided in groups of high and low risk according to the parameter cut-offs defined in our previous work. In a second step, the cut-offs were adjusted to the present data. Univariate and multivariate Cox regression was performed for the pooled data consisting of the current and the previously described patient group (N = 68). In multivariate Cox regression, clinically relevant parameters were included. Results Univariate Cox regression using the previously published cut-off values revealed TLG (hazard ratio (HR) = 3) and ASP (HR = 3) as significant predictors for PFS. For OS MTV (HR = 2.7) and ASP (HR = 5.9) were significant predictors. Using the adjusted cutoffs MTV (HR = 2.9/3.3), TLG (HR = 3.1/3.3) and ASP (HR = 3.1/5.9) were prognostic for PFS/OS. In the pooled data, multivariate Cox regression revealed a significant prognostic value with respect to PFS/OS for MTV (HR = 2.3/2.1), SUVmax (HR = 2.1/2.5), TLG (HR = 3.5/3.6), and ASP (HR = 3.4/4.4). Conclusions Our results confirm the independent prognostic value of ASP of the pretherapeutic FDG uptake in the primary tumor in patients with head and neck cancer. Moreover, these results demonstrate that ASP can be determined unambiguously across different sites.