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

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Frank Hofheinz - , Helmholtz-Zentrum Dresden-Rossendorf (Autor:in)
  • Alexandr Lougovski - , Helmholtz-Zentrum Dresden-Rossendorf (Autor:in)
  • Klaus Zöphel - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Nuklearmedizin (Autor:in)
  • Maria Hentschel - , Universitätsklinikum Carl Gustav Carus Dresden, Klinik und Poliklinik für Nuklearmedizin (Autor:in)
  • Ingo G. Steffen - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Ivayla Apostolova - , Otto-von-Guericke-Universität Magdeburg (Autor:in)
  • Florian Wedel - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Ralph Buchert - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Michael Baumann - , Klinik und Poliklinik für Strahlentherapie und Radioonkologie, OncoRay ZIC - Nationales Zentrum für Strahlenforschung in der Onkologie (Partner/Träger: UKD, HZDR), Universitätsklinikum Carl Gustav Carus Dresden, Helmholtz-Zentrum Dresden-Rossendorf (Autor:in)
  • Winfried Brenner - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Jörg Kotzerke - , Klinik und Poliklinik für Nuklearmedizin, Helmholtz-Zentrum Dresden-Rossendorf, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Jörg van den Hoff - , Klinik und Poliklinik für Nuklearmedizin, Helmholtz-Zentrum Dresden-Rossendorf, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)

Abstract

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.

Details

OriginalspracheEnglisch
Seiten (von - bis)429-437
Seitenumfang9
FachzeitschriftEuropean journal of nuclear medicine and molecular imaging
Jahrgang42
Ausgabenummer3
PublikationsstatusVeröffentlicht - März 2015
Peer-Review-StatusJa

Externe IDs

PubMed 25416633

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Asphericity, FDG, Head and neck cancer, PET, Prognostic value, Tumor heterogeneity