头颈部鳞状细胞癌根治性放化疗后 DW-MRI 与 F-FDG PET/CT 参数的相关性。
Correlations between DW-MRI and F-FDG PET/CT parameters in head and neck squamous cell carcinoma following definitive chemo-radiotherapy.
机构信息
School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, King's College, London, UK.
Department of Neuroradiology, King's College Hospital NHS Foundation Trust, London, UK.
出版信息
Cancer Rep (Hoboken). 2021 Aug;4(4):e1360. doi: 10.1002/cnr2.1360. Epub 2021 May 7.
BACKGROUND
Posttreatment diffusion-weighted magnetic resonance imaging (DW-MRI) and 18F-fluorodeoxygluocose ( F-FDG) positron emission tomography (PET) with computed tomography (PET/CT) have potential prognostic value following chemo-radiotherapy (CRT) for head and neck squamous cell carcinoma (HNSCC). Correlations between these PET/CT (standardized uptake value or SUV) and DW-MRI (apparent diffusion coefficient or ADC) parameters have only been previously explored in the pretreatment setting.
AIM
To evaluate stage III and IV HNSCC at 12-weeks post-CRT for the correlation between SUV and ADC values and their interval changes from pretreatment imaging.
METHODS
Fifty-six patients (45 male, 11 female, mean age 59.9 + - 7.38) with stage 3 and 4 HNSCC patients underwent 12-week posttreatment DW-MRI and F-FDG PET/CT studies in this prospective study. There were 41/56 patients in the cohort with human papilloma virus-related oropharyngeal cancer (HPV OPC). DW-MRI (ADC and ADC and F-FDG PET/CT (SUV and SUV ratio to liver) parameters were measured at the site of primary tumors (n = 48) and the largest lymph nodes (n = 52). Kendall's tau evaluated the correlation between DW-MRI and F-FDG PET/CT parameters. Mann-Whitney test compared the post-CRT PET/CT and DW-MRI parameters between those participants with and without 2-year disease-free survival (DFS).
RESULTS
There was no correlation between DW-MRI and F-FDG PET/CT parameters on 12-week posttreatment imaging (P = .455-.794; tau = -0.075-0.25) or their interval changes from pretreatment to 12-week posttreatment imaging (P = .1-.946; tau = -0.194-0.044). The primary tumor ADC (P = .03) and the interval change in nodal ADC (P = .05) predicted 2-year DFS but none of the F-FDG PET/CT parameters were associated with 2-year DFS.
CONCLUSIONS
There is no correlation between the quantitative DWI-MRI and F-FDG PET/CT parameters derived from 12-week post-CRT studies. These parameters may be independent biomarkers however in this HPV OPC dominant cohort, only selected ADC parameters demonstrated prognostic significance. Study was prospectively registered at http://www.controlled-trials.com/ISRCTN58327080.
背景
放化疗后，扩散加权磁共振成像（DW-MRI）和 18F-氟代脱氧葡萄糖（F-FDG）正电子发射断层扫描（PET）联合计算机断层扫描（PET/CT）对头颈部鳞状细胞癌（HNSCC）患者具有潜在的预后价值。这些 PET/CT（标准化摄取值或 SUV）和 DW-MRI（表观扩散系数或 ADC）参数之间的相关性仅在预处理时进行了探讨。
目的
评估放化疗后 12 周的 III 期和 IV 期 HNSCC，评估 SUV 和 ADC 值及其与预处理成像的间隔变化之间的相关性。
方法
56 例（45 例男性，11 例女性，平均年龄 59.9 + - 7.38 岁）III 和 IV 期 HNSCC 患者在本前瞻性研究中进行了 12 周的治疗后 DW-MRI 和 F-FDG PET/CT 研究。在队列中有 41/56 例 HPV 相关口咽癌（HPV OPC）患者。DW-MRI（ADC）和 F-FDG PET/CT（SUV 和 SUV 与肝脏的比值）参数在原发肿瘤部位（n = 48）和最大淋巴结（n = 52）处进行测量。Kendall's tau 用于评估 DW-MRI 和 F-FDG PET/CT 参数之间的相关性。Mann-Whitney 检验比较了 2 年无病生存（DFS）患者和无 2 年 DFS 患者的放化疗后 PET/CT 和 DW-MRI 参数。
结果
治疗后 12 周时，DW-MRI 和 F-FDG PET/CT 参数之间无相关性（P = .455-.794；tau = -0.075-0.25）或与预处理至 12 周时的间隔变化无相关性（P = .1-.946；tau = -0.194-0.044）。原发肿瘤 ADC（P = .03）和淋巴结 ADC 的间隔变化（P = .05）预测 2 年 DFS，但 F-FDG PET/CT 参数均与 2 年 DFS 无关。
结论
放化疗后 12 周的定量 DWI-MRI 和 F-FDG PET/CT 参数之间无相关性。这些参数可能是独立的生物标志物，但在 HPV OPC 为主的队列中，只有部分 ADC 参数具有预后意义。该研究在 http://www.controlled-trials.com/ISRCTN58327080 进行了前瞻性注册。
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