Value of pretreatment 18F-FLT PET/CT and 18F-FDG PET/CT uptake heterogeneity for early prediction of treatment outcome in locally advanced nasopharyngeal carcinoma
Background and purpose: Nasopharyngeal carcinoma is one of the most common head and neck malignancies in Southeast Asia. Radiotherapy combined with chemotherapy is the main treatment for patients with locally advanced nasopharyngeal carcinoma (LANPC), however, different patients have various levels...
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| Format: | Article |
| Language: | English |
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Editorial Office of China Oncology
2022-04-01
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| Series: | Zhongguo aizheng zazhi |
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| Online Access: | http://www.china-oncology.com/fileup/1007-3639/PDF/1651908583831-535447667.pdf |
| _version_ | 1811272265078145024 |
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| author | MA Guang, OU Xiaomin, HU Chaosu, SONG Shaoli, YANG Zhongyi |
| author_facet | MA Guang, OU Xiaomin, HU Chaosu, SONG Shaoli, YANG Zhongyi |
| author_sort | MA Guang, OU Xiaomin, HU Chaosu, SONG Shaoli, YANG Zhongyi |
| collection | DOAJ |
| description | Background and purpose: Nasopharyngeal carcinoma is one of the most common head and neck malignancies in Southeast Asia. Radiotherapy combined with chemotherapy is the main treatment for patients with locally advanced nasopharyngeal carcinoma (LANPC), however, different patients have various levels of clinical benefit. Therefore, early and accurate evaluation of the prognosis of LANPC after radiotherapy and chemotherapy is of great significance for clinical treatment decision-making. This paper aimed to evaluate and compare the value of 18F-Fluorothymidine (FLT) and 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging parameters in predicting the prognosis of patients with LANPC after radiotherapy and chemotherapy. Methods: Patients with LANPC who all received intensity-modulated radiation therapy (IMRT) and neoadjuvant chemotherapy (NACT) in Fudan University Shanghai Cancer Center from May 2012 to January 2015 were retrospectively selected. Clinical follow-up endpoint was progression-free survival (PFS), defined as the time from the beginning of treatment to tumor progression or death from any cause. The focus evaluation was based on the Response Evaluation Criteria in Solid Tumor 1.1 (RECIST 1.1). Pretreatment 18F-FLT and 18F-FDG PET/CT imaging were performed respectively. And the time interval between the two imaging was maintained within 1 week. The main parameters were measured, including maximal standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), proliferative tumor volume (PTV)/metabolic tumor volume (MTV), total lesion thymidine (TLT)/ total lesion glucose (TLG) and tumor heterogeneity index (HI). Spearman rank correlation coefficient was used to analyze the correlation between the above PET/CT parameters and patients with metastasis/recurrence of LANPC. Then, the best cut-off value was determined by the receiver operating characteristic (ROC) curve, and the predictive ability was evaluated by the ROC curve. PFS was evaluated by the Kaplan-Meier method and log-rank test. Results: Among the 24 patients, 6 had metastasis or recurrence. The median follow-up time was 74.51 months. Spearman rank correlation coefficient analysis showed that HI(T-FLT-70%SUVmax) was associated with metastasis or recurrence (P=0.04); ROC curve analysis showed that the sensitivity of HI(T-FLT-70%SUVmax) in predicting metastatic or recurrent nasopharyngeal carcinoma was 80.00%, and the specificity was 79.90% (P=0.043). Survival analysis showed that when HI(T-FLT-70%SUVmax)>0.828, the median PFS was 57.99 months, which was significantly shorter compared with patients with HI(T-FLT-70%SUVmax)0≤0.828 (P=0.014). Conclusion: HI based on 18F-FLT PET/CT may be useful for predicting the prognosis of patients with LANPC receiving radiotherapy and chemotherapy. |
| first_indexed | 2024-04-12T22:37:16Z |
| format | Article |
| id | doaj.art-5d647a9b620f41c7815100214422a259 |
| institution | Directory Open Access Journal |
| issn | 1007-3639 |
| language | English |
| last_indexed | 2024-04-12T22:37:16Z |
| publishDate | 2022-04-01 |
| publisher | Editorial Office of China Oncology |
| record_format | Article |
| series | Zhongguo aizheng zazhi |
| spelling | doaj.art-5d647a9b620f41c7815100214422a2592022-12-22T03:13:50ZengEditorial Office of China OncologyZhongguo aizheng zazhi1007-36392022-04-0132430931510.19401/j.cnki.1007-3639.2022.04.003Value of pretreatment 18F-FLT PET/CT and 18F-FDG PET/CT uptake heterogeneity for early prediction of treatment outcome in locally advanced nasopharyngeal carcinomaMA Guang, OU Xiaomin, HU Chaosu, SONG Shaoli, YANG Zhongyi01. Department of Nuclear Medicine, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University; Center for Biomedical Imaging, Fudan University; Shanghai Engineering Research Center for Molecular Imaging Probes, Shanghai 200032, China;2. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, ChinaBackground and purpose: Nasopharyngeal carcinoma is one of the most common head and neck malignancies in Southeast Asia. Radiotherapy combined with chemotherapy is the main treatment for patients with locally advanced nasopharyngeal carcinoma (LANPC), however, different patients have various levels of clinical benefit. Therefore, early and accurate evaluation of the prognosis of LANPC after radiotherapy and chemotherapy is of great significance for clinical treatment decision-making. This paper aimed to evaluate and compare the value of 18F-Fluorothymidine (FLT) and 18F-Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging parameters in predicting the prognosis of patients with LANPC after radiotherapy and chemotherapy. Methods: Patients with LANPC who all received intensity-modulated radiation therapy (IMRT) and neoadjuvant chemotherapy (NACT) in Fudan University Shanghai Cancer Center from May 2012 to January 2015 were retrospectively selected. Clinical follow-up endpoint was progression-free survival (PFS), defined as the time from the beginning of treatment to tumor progression or death from any cause. The focus evaluation was based on the Response Evaluation Criteria in Solid Tumor 1.1 (RECIST 1.1). Pretreatment 18F-FLT and 18F-FDG PET/CT imaging were performed respectively. And the time interval between the two imaging was maintained within 1 week. The main parameters were measured, including maximal standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), proliferative tumor volume (PTV)/metabolic tumor volume (MTV), total lesion thymidine (TLT)/ total lesion glucose (TLG) and tumor heterogeneity index (HI). Spearman rank correlation coefficient was used to analyze the correlation between the above PET/CT parameters and patients with metastasis/recurrence of LANPC. Then, the best cut-off value was determined by the receiver operating characteristic (ROC) curve, and the predictive ability was evaluated by the ROC curve. PFS was evaluated by the Kaplan-Meier method and log-rank test. Results: Among the 24 patients, 6 had metastasis or recurrence. The median follow-up time was 74.51 months. Spearman rank correlation coefficient analysis showed that HI(T-FLT-70%SUVmax) was associated with metastasis or recurrence (P=0.04); ROC curve analysis showed that the sensitivity of HI(T-FLT-70%SUVmax) in predicting metastatic or recurrent nasopharyngeal carcinoma was 80.00%, and the specificity was 79.90% (P=0.043). Survival analysis showed that when HI(T-FLT-70%SUVmax)>0.828, the median PFS was 57.99 months, which was significantly shorter compared with patients with HI(T-FLT-70%SUVmax)0≤0.828 (P=0.014). Conclusion: HI based on 18F-FLT PET/CT may be useful for predicting the prognosis of patients with LANPC receiving radiotherapy and chemotherapy.http://www.china-oncology.com/fileup/1007-3639/PDF/1651908583831-535447667.pdf|pet/ct|locally advanced nasopharyngeal carcinoma|predicting|prognosis |
| spellingShingle | MA Guang, OU Xiaomin, HU Chaosu, SONG Shaoli, YANG Zhongyi Value of pretreatment 18F-FLT PET/CT and 18F-FDG PET/CT uptake heterogeneity for early prediction of treatment outcome in locally advanced nasopharyngeal carcinoma Zhongguo aizheng zazhi |pet/ct|locally advanced nasopharyngeal carcinoma|predicting|prognosis |
| title | Value of pretreatment 18F-FLT PET/CT and 18F-FDG PET/CT uptake heterogeneity for early prediction of treatment outcome in locally advanced nasopharyngeal carcinoma |
| title_full | Value of pretreatment 18F-FLT PET/CT and 18F-FDG PET/CT uptake heterogeneity for early prediction of treatment outcome in locally advanced nasopharyngeal carcinoma |
| title_fullStr | Value of pretreatment 18F-FLT PET/CT and 18F-FDG PET/CT uptake heterogeneity for early prediction of treatment outcome in locally advanced nasopharyngeal carcinoma |
| title_full_unstemmed | Value of pretreatment 18F-FLT PET/CT and 18F-FDG PET/CT uptake heterogeneity for early prediction of treatment outcome in locally advanced nasopharyngeal carcinoma |
| title_short | Value of pretreatment 18F-FLT PET/CT and 18F-FDG PET/CT uptake heterogeneity for early prediction of treatment outcome in locally advanced nasopharyngeal carcinoma |
| title_sort | value of pretreatment 18f flt pet ct and 18f fdg pet ct uptake heterogeneity for early prediction of treatment outcome in locally advanced nasopharyngeal carcinoma |
| topic | |pet/ct|locally advanced nasopharyngeal carcinoma|predicting|prognosis |
| url | http://www.china-oncology.com/fileup/1007-3639/PDF/1651908583831-535447667.pdf |
| work_keys_str_mv | AT maguangouxiaominhuchaosusongshaoliyangzhongyi valueofpretreatment18ffltpetctand18ffdgpetctuptakeheterogeneityforearlypredictionoftreatmentoutcomeinlocallyadvancednasopharyngealcarcinoma |