18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization
Purpose18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is utilized for staging and treatment planning of head and neck squamous cell carcinomas (HNSCC). Some older publications on the prognostic relevance showed inconclusive results, most probably due to small study sizes. This study e...
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| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.870319/full |
| _version_ | 1828795244622118912 |
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| author | Sebastian Zschaeck Sebastian Zschaeck Sebastian Zschaeck Sebastian Zschaeck Sebastian Zschaeck Julian Weingärtner Julian Weingärtner Elia Lombardo Sebastian Marschner Sebastian Marschner Marina Hajiyianni Marcus Beck Daniel Zips Daniel Zips Daniel Zips Yimin Li Qin Lin Holger Amthauer Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Jörg van den Hoff Volker Budach Jörg Kotzerke Jörg Kotzerke Jörg Kotzerke Konstantinos Ferentinos Efstratios Karagiannis David Kaul Vincent Gregoire Adrien Holzgreve Nathalie L. Albert Pavel Nikulin Michael Bachmann Klaus Kopka Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Michael Baumann Michael Baumann Michael Baumann Michael Baumann Michael Baumann Joanna Kazmierska Joanna Kazmierska Paulina Cegla Witold Cholewinski Witold Cholewinski Iosif Strouthos Klaus Zöphel Klaus Zöphel Klaus Zöphel Klaus Zöphel Ewa Majchrzak Guillaume Landry Claus Belka Claus Belka Carmen Stromberger Frank Hofheinz |
| author_facet | Sebastian Zschaeck Sebastian Zschaeck Sebastian Zschaeck Sebastian Zschaeck Sebastian Zschaeck Julian Weingärtner Julian Weingärtner Elia Lombardo Sebastian Marschner Sebastian Marschner Marina Hajiyianni Marcus Beck Daniel Zips Daniel Zips Daniel Zips Yimin Li Qin Lin Holger Amthauer Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Jörg van den Hoff Volker Budach Jörg Kotzerke Jörg Kotzerke Jörg Kotzerke Konstantinos Ferentinos Efstratios Karagiannis David Kaul Vincent Gregoire Adrien Holzgreve Nathalie L. Albert Pavel Nikulin Michael Bachmann Klaus Kopka Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Michael Baumann Michael Baumann Michael Baumann Michael Baumann Michael Baumann Joanna Kazmierska Joanna Kazmierska Paulina Cegla Witold Cholewinski Witold Cholewinski Iosif Strouthos Klaus Zöphel Klaus Zöphel Klaus Zöphel Klaus Zöphel Ewa Majchrzak Guillaume Landry Claus Belka Claus Belka Carmen Stromberger Frank Hofheinz |
| author_sort | Sebastian Zschaeck |
| collection | DOAJ |
| description | Purpose18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is utilized for staging and treatment planning of head and neck squamous cell carcinomas (HNSCC). Some older publications on the prognostic relevance showed inconclusive results, most probably due to small study sizes. This study evaluates the prognostic and potentially predictive value of FDG-PET in a large multi-center analysis.MethodsOriginal analysis of individual FDG-PET and patient data from 16 international centers (8 institutional datasets, 8 public repositories) with 1104 patients. All patients received curative intent radiotherapy/chemoradiation (CRT) and pre-treatment FDG-PET imaging. Primary tumors were semi-automatically delineated for calculation of SUVmax, SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Cox regression analyses were performed for event-free survival (EFS), overall survival (OS), loco-regional control (LRC) and freedom from distant metastases (FFDM).ResultsFDG-PET parameters were associated with patient outcome in the whole cohort regarding clinical endpoints (EFS, OS, LRC, FFDM), in uni- and multivariate Cox regression analyses. Several previously published cut-off values were successfully validated. Subgroup analyses identified tumor- and human papillomavirus (HPV) specific parameters. In HPV positive oropharynx cancer (OPC) SUVmax was well suited to identify patients with excellent LRC for organ preservation. Patients with SUVmax of 14 or less were unlikely to develop loco-regional recurrence after definitive CRT. In contrast FDG PET parameters deliver only limited prognostic information in laryngeal cancer.ConclusionFDG-PET parameters bear considerable prognostic value in HNSCC and potential predictive value in subgroups of patients, especially regarding treatment de-intensification and organ-preservation. The potential predictive value needs further validation in appropriate control groups. Further research on advanced imaging approaches including radiomics or artificial intelligence methods should implement the identified cut-off values as benchmark routine imaging parameters. |
| first_indexed | 2024-12-12T04:00:35Z |
| format | Article |
| id | doaj.art-2f07b591baee437aa851d7fe7869f85d |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-12T04:00:35Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-2f07b591baee437aa851d7fe7869f85d2022-12-22T00:39:04ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-06-011210.3389/fonc.2022.87031987031918F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment IndividualizationSebastian Zschaeck0Sebastian Zschaeck1Sebastian Zschaeck2Sebastian Zschaeck3Sebastian Zschaeck4Julian Weingärtner5Julian Weingärtner6Elia Lombardo7Sebastian Marschner8Sebastian Marschner9Marina Hajiyianni10Marcus Beck11Daniel Zips12Daniel Zips13Daniel Zips14Yimin Li15Qin Lin16Holger Amthauer17Esther G. C. Troost18Esther G. C. Troost19Esther G. C. Troost20Esther G. C. Troost21Esther G. C. Troost22Esther G. C. Troost23Esther G. C. Troost24Jörg van den Hoff25Volker Budach26Jörg Kotzerke27Jörg Kotzerke28Jörg Kotzerke29Konstantinos Ferentinos30Efstratios Karagiannis31David Kaul32Vincent Gregoire33Adrien Holzgreve34Nathalie L. Albert35Pavel Nikulin36Michael Bachmann37Klaus Kopka38Mechthild Krause39Mechthild Krause40Mechthild Krause41Mechthild Krause42Mechthild Krause43Mechthild Krause44Mechthild Krause45Michael Baumann46Michael Baumann47Michael Baumann48Michael Baumann49Michael Baumann50Joanna Kazmierska51Joanna Kazmierska52Paulina Cegla53Witold Cholewinski54Witold Cholewinski55Iosif Strouthos56Klaus Zöphel57Klaus Zöphel58Klaus Zöphel59Klaus Zöphel60Ewa Majchrzak61Guillaume Landry62Claus Belka63Claus Belka64Carmen Stromberger65Frank Hofheinz66Department of Radiation Oncology, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany Berlin Institute of Health (BIH), Berlin, GermanyDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, GermanyGerman Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ) Heidelberg, Germany, GermanyOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden – Rossendorf, Dresden, GermanyDepartment of Radiation Oncology, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany Berlin Institute of Health (BIH), Berlin, GermanyDepartment of Radiation Oncology, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, GermanyDepartment of Radiation Oncology, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, GermanyGerman Cancer Consortium (DKTK), Partner Site Munich, Munich, GermanyDepartment of Radiation Oncology, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Radiation Oncology, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Radiation Oncology, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyGerman Cancer Consortium (DKTK), Partner Site Tübingen, and German Cancer Research Center (DKFZ) Heidelberg, Germany, GermanyDepartment of Radiation Oncology, University Hospital and Medical Faculty, Eberhard Karls University Tübingen, Tübingen, Germany0Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, China0Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, China1Department of Nuclear Medicine, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, GermanyGerman Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ) Heidelberg, Germany, GermanyOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden – Rossendorf, Dresden, Germany2Institute of Radiooncology – OncoRay, Helmholtz-Zentrum Dresden - Rossendorf, Dresden, Germany3National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany4Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany5 Helmholtz Association/Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany6Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, GermanyDepartment of Radiation Oncology, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyGerman Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ) Heidelberg, Germany, GermanyOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden – Rossendorf, Dresden, Germany7Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden, Germany8Department of Radiation Oncology, German Oncology Center, European University Cyprus, Limassol, Cyprus8Department of Radiation Oncology, German Oncology Center, European University Cyprus, Limassol, CyprusDepartment of Radiation Oncology, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany9Radiation Oncology Department, Leon Bérard Cancer Center, Lyon, France0Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Germany0Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Germany6Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany6Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany6Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, GermanyDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, GermanyGerman Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ) Heidelberg, Germany, GermanyOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden – Rossendorf, Dresden, Germany2Institute of Radiooncology – OncoRay, Helmholtz-Zentrum Dresden - Rossendorf, Dresden, Germany3National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany4Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany5 Helmholtz Association/Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, GermanyDepartment of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, GermanyGerman Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ) Heidelberg, Germany, GermanyOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden – Rossendorf, Dresden, Germany2Institute of Radiooncology – OncoRay, Helmholtz-Zentrum Dresden - Rossendorf, Dresden, Germany1German Cancer Research Center (DKFZ), Heidelberg, Germany2Electroradiology Department, University of Medical Sciences, Poznan, Poland3Radiotherapy Department II, Greater Poland Cancer Centre, Poznan, Poland4Department of Nuclear Medicine, Greater Poland Cancer Centre, Poznan, Poland2Electroradiology Department, University of Medical Sciences, Poznan, Poland4Department of Nuclear Medicine, Greater Poland Cancer Centre, Poznan, Poland8Department of Radiation Oncology, German Oncology Center, European University Cyprus, Limassol, CyprusGerman Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ) Heidelberg, Germany, GermanyOncoRay – National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden – Rossendorf, Dresden, Germany7Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden, Germany5Department of Nuclear Medicine, Klinikum Chemnitz gGmbH, Chemnitz, Germany6Department of Head and Neck Surgery, Poznan University of Medical Sciences, Greater Poland Cancer Centre, Poznan, PolandDepartment of Radiation Oncology, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, GermanyDepartment of Radiation Oncology, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich, GermanyGerman Cancer Consortium (DKTK), Partner Site Munich, Munich, GermanyDepartment of Radiation Oncology, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany6Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, GermanyPurpose18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is utilized for staging and treatment planning of head and neck squamous cell carcinomas (HNSCC). Some older publications on the prognostic relevance showed inconclusive results, most probably due to small study sizes. This study evaluates the prognostic and potentially predictive value of FDG-PET in a large multi-center analysis.MethodsOriginal analysis of individual FDG-PET and patient data from 16 international centers (8 institutional datasets, 8 public repositories) with 1104 patients. All patients received curative intent radiotherapy/chemoradiation (CRT) and pre-treatment FDG-PET imaging. Primary tumors were semi-automatically delineated for calculation of SUVmax, SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Cox regression analyses were performed for event-free survival (EFS), overall survival (OS), loco-regional control (LRC) and freedom from distant metastases (FFDM).ResultsFDG-PET parameters were associated with patient outcome in the whole cohort regarding clinical endpoints (EFS, OS, LRC, FFDM), in uni- and multivariate Cox regression analyses. Several previously published cut-off values were successfully validated. Subgroup analyses identified tumor- and human papillomavirus (HPV) specific parameters. In HPV positive oropharynx cancer (OPC) SUVmax was well suited to identify patients with excellent LRC for organ preservation. Patients with SUVmax of 14 or less were unlikely to develop loco-regional recurrence after definitive CRT. In contrast FDG PET parameters deliver only limited prognostic information in laryngeal cancer.ConclusionFDG-PET parameters bear considerable prognostic value in HNSCC and potential predictive value in subgroups of patients, especially regarding treatment de-intensification and organ-preservation. The potential predictive value needs further validation in appropriate control groups. Further research on advanced imaging approaches including radiomics or artificial intelligence methods should implement the identified cut-off values as benchmark routine imaging parameters.https://www.frontiersin.org/articles/10.3389/fonc.2022.870319/fullhead and neck squamous cell carcinoma (HNSCC)fluorodeoxyglucose positron emission tomography (FDG PET)radiotherapymetabolic tumor volume (MTV)standardized uptake value (SUV) |
| spellingShingle | Sebastian Zschaeck Sebastian Zschaeck Sebastian Zschaeck Sebastian Zschaeck Sebastian Zschaeck Julian Weingärtner Julian Weingärtner Elia Lombardo Sebastian Marschner Sebastian Marschner Marina Hajiyianni Marcus Beck Daniel Zips Daniel Zips Daniel Zips Yimin Li Qin Lin Holger Amthauer Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Esther G. C. Troost Jörg van den Hoff Volker Budach Jörg Kotzerke Jörg Kotzerke Jörg Kotzerke Konstantinos Ferentinos Efstratios Karagiannis David Kaul Vincent Gregoire Adrien Holzgreve Nathalie L. Albert Pavel Nikulin Michael Bachmann Klaus Kopka Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Mechthild Krause Michael Baumann Michael Baumann Michael Baumann Michael Baumann Michael Baumann Joanna Kazmierska Joanna Kazmierska Paulina Cegla Witold Cholewinski Witold Cholewinski Iosif Strouthos Klaus Zöphel Klaus Zöphel Klaus Zöphel Klaus Zöphel Ewa Majchrzak Guillaume Landry Claus Belka Claus Belka Carmen Stromberger Frank Hofheinz 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization Frontiers in Oncology head and neck squamous cell carcinoma (HNSCC) fluorodeoxyglucose positron emission tomography (FDG PET) radiotherapy metabolic tumor volume (MTV) standardized uptake value (SUV) |
| title | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
| title_full | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
| title_fullStr | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
| title_full_unstemmed | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
| title_short | 18F-Fluorodeoxyglucose Positron Emission Tomography of Head and Neck Cancer: Location and HPV Specific Parameters for Potential Treatment Individualization |
| title_sort | 18f fluorodeoxyglucose positron emission tomography of head and neck cancer location and hpv specific parameters for potential treatment individualization |
| topic | head and neck squamous cell carcinoma (HNSCC) fluorodeoxyglucose positron emission tomography (FDG PET) radiotherapy metabolic tumor volume (MTV) standardized uptake value (SUV) |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.870319/full |
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