Dynamic Characteristics and Predictive Capability of Tumor Voxel Dose–Response Assessed Using 18F-FDG PET/CT Imaging Feedback
PurposeTumor voxel dose–response matrix (DRM) can be quantified using feedback from serial FDG-PET/CT imaging acquired during radiotherapy. This study investigated the dynamic characteristics and the predictive capability of DRM.MethodsFDG-PET/CT images were acquired before and weekly during standar...
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| Format: | Article |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.876861/full |
| _version_ | 1811291239123779584 |
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| author | Shupeng Chen An Qin Di Yan Di Yan |
| author_facet | Shupeng Chen An Qin Di Yan Di Yan |
| author_sort | Shupeng Chen |
| collection | DOAJ |
| description | PurposeTumor voxel dose–response matrix (DRM) can be quantified using feedback from serial FDG-PET/CT imaging acquired during radiotherapy. This study investigated the dynamic characteristics and the predictive capability of DRM.MethodsFDG-PET/CT images were acquired before and weekly during standard chemoradiotherapy with the treatment dose 2 Gy × 35 from 31 head and neck cancer patients. For each patient, deformable image registration was performed between the pretreatment/baseline PET/CT image and each weekly PET/CT image. Tumor voxel DRM was derived using linear regression on the logarithm of the weekly standard uptake value (SUV) ratios for each tumor voxel, such as SUV measured at a dose level normalized to the baseline SUV0. The dynamic characteristics were evaluated by comparing the DRMi estimated using a single feedback image acquired at the ith treatment week (i = 1, 2, 3, or 4) to the DRM estimated using the last feedback image for each patient. The predictive capability of the DRM estimated using 1 or 2 feedback images was evaluated using the receiver operating characteristic test with respect to the treatment outcome of tumor local–regional control or failure.ResultsThe mean ± SD of tumor voxel SUV measured at the pretreatment and the 1st, 2nd, 3rd, 4th, and last treatment weeks was 6.76 ± 3.69, 5.72 ± 3.43, 3.85 ± 2.22, 3.27 ± 2.25, 2.5 ± 1.79, and 2.23 ± 1.27, respectively. The deviations between the DRMi estimated using the single feedback image obtained at the ith week and the last feedback image were 0.86 ± 4.87, −0.06 ± 0.3, −0.09 ± 0.17, and −0.09 ± 0.12 for DRM1, DRM2, DRM3, and DRM4, respectively. The predictive capability of DRM3 and DRM4 was significant (p < 0.001). The area under the curve (AUC) was increased with the increase in treatment dose level. The DRMs constructed using the single feedback image achieved an AUC of 0.86~1. The AUC was slightly improved to 0.94~1 for the DRMs estimated using 2 feedback images.ConclusionTumor voxel metabolic activity measured using FDG-PET/CT fluctuated noticeably during the first 2 treatment weeks and obtained a stabilized reduction rate thereafter. Tumor voxel DRM constructed using a single FDG-PET/CT feedback image after the 2nd treatment week (>20 Gy) has a good predictive capability. The predictive capability improved continuously using a later feedback image and marginally improved when two feedback images were applied. |
| first_indexed | 2024-04-13T04:26:21Z |
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| id | doaj.art-f68f5476ebee4c2d98a5853aeb938f7f |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-13T04:26:21Z |
| publishDate | 2022-07-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-f68f5476ebee4c2d98a5853aeb938f7f2022-12-22T03:02:32ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-07-011210.3389/fonc.2022.876861876861Dynamic Characteristics and Predictive Capability of Tumor Voxel Dose–Response Assessed Using 18F-FDG PET/CT Imaging FeedbackShupeng Chen0An Qin1Di Yan2Di Yan3Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, United StatesRadiation Oncology, William Beaumont Hospital, Royal Oak, MI, United StatesRadiation Oncology, William Beaumont Hospital, Royal Oak, MI, United StatesRadiation Oncology, Huaxi Hospital/School of Medicine, Chengdu, ChinaPurposeTumor voxel dose–response matrix (DRM) can be quantified using feedback from serial FDG-PET/CT imaging acquired during radiotherapy. This study investigated the dynamic characteristics and the predictive capability of DRM.MethodsFDG-PET/CT images were acquired before and weekly during standard chemoradiotherapy with the treatment dose 2 Gy × 35 from 31 head and neck cancer patients. For each patient, deformable image registration was performed between the pretreatment/baseline PET/CT image and each weekly PET/CT image. Tumor voxel DRM was derived using linear regression on the logarithm of the weekly standard uptake value (SUV) ratios for each tumor voxel, such as SUV measured at a dose level normalized to the baseline SUV0. The dynamic characteristics were evaluated by comparing the DRMi estimated using a single feedback image acquired at the ith treatment week (i = 1, 2, 3, or 4) to the DRM estimated using the last feedback image for each patient. The predictive capability of the DRM estimated using 1 or 2 feedback images was evaluated using the receiver operating characteristic test with respect to the treatment outcome of tumor local–regional control or failure.ResultsThe mean ± SD of tumor voxel SUV measured at the pretreatment and the 1st, 2nd, 3rd, 4th, and last treatment weeks was 6.76 ± 3.69, 5.72 ± 3.43, 3.85 ± 2.22, 3.27 ± 2.25, 2.5 ± 1.79, and 2.23 ± 1.27, respectively. The deviations between the DRMi estimated using the single feedback image obtained at the ith week and the last feedback image were 0.86 ± 4.87, −0.06 ± 0.3, −0.09 ± 0.17, and −0.09 ± 0.12 for DRM1, DRM2, DRM3, and DRM4, respectively. The predictive capability of DRM3 and DRM4 was significant (p < 0.001). The area under the curve (AUC) was increased with the increase in treatment dose level. The DRMs constructed using the single feedback image achieved an AUC of 0.86~1. The AUC was slightly improved to 0.94~1 for the DRMs estimated using 2 feedback images.ConclusionTumor voxel metabolic activity measured using FDG-PET/CT fluctuated noticeably during the first 2 treatment weeks and obtained a stabilized reduction rate thereafter. Tumor voxel DRM constructed using a single FDG-PET/CT feedback image after the 2nd treatment week (>20 Gy) has a good predictive capability. The predictive capability improved continuously using a later feedback image and marginally improved when two feedback images were applied.https://www.frontiersin.org/articles/10.3389/fonc.2022.876861/fullFDG-PET/CT imaging feedbacktumor voxel dose–response DRMdynamic characteristics and predictive capabilityadaptive dose paintingadaptive radiotherapy |
| spellingShingle | Shupeng Chen An Qin Di Yan Di Yan Dynamic Characteristics and Predictive Capability of Tumor Voxel Dose–Response Assessed Using 18F-FDG PET/CT Imaging Feedback Frontiers in Oncology FDG-PET/CT imaging feedback tumor voxel dose–response DRM dynamic characteristics and predictive capability adaptive dose painting adaptive radiotherapy |
| title | Dynamic Characteristics and Predictive Capability of Tumor Voxel Dose–Response Assessed Using 18F-FDG PET/CT Imaging Feedback |
| title_full | Dynamic Characteristics and Predictive Capability of Tumor Voxel Dose–Response Assessed Using 18F-FDG PET/CT Imaging Feedback |
| title_fullStr | Dynamic Characteristics and Predictive Capability of Tumor Voxel Dose–Response Assessed Using 18F-FDG PET/CT Imaging Feedback |
| title_full_unstemmed | Dynamic Characteristics and Predictive Capability of Tumor Voxel Dose–Response Assessed Using 18F-FDG PET/CT Imaging Feedback |
| title_short | Dynamic Characteristics and Predictive Capability of Tumor Voxel Dose–Response Assessed Using 18F-FDG PET/CT Imaging Feedback |
| title_sort | dynamic characteristics and predictive capability of tumor voxel dose response assessed using 18f fdg pet ct imaging feedback |
| topic | FDG-PET/CT imaging feedback tumor voxel dose–response DRM dynamic characteristics and predictive capability adaptive dose painting adaptive radiotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.876861/full |
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