Aren Ewa, Trada Yuvnik, Lee Mark, Deshpande Shrikant, Jameson Michael G, Johnston Meredith, Berry Megan, Estall Vanessa, Fowler Allan
Cancer Therapy Centre, Liverpool Hospital, Sydney, New South Wales, Australia.
Calvary Mater Newcastle, Newcastle, New South Wales, Australia.
J Med Imaging Radiat Oncol. 2023 Feb;67(1):89-97. doi: 10.1111/1754-9485.13486. Epub 2022 Oct 27.
Tumour recurrences after treatment of head and neck squamous cell carcinoma (HNSCC) are more likely to originate from regions of high-baseline FDG-PET uptake. Mid-treatment functional imaging can potentially predict for higher risk of tumour recurrence. The aim of this study is to correlate the location of locoregional tumour recurrence with baseline FDG-PET metabolic volumes and mid-treatment FDG-PET metabolic volumes in patients with HNSCC following definitive radiotherapy.
A total of 23 patients with 26 local and/or regional recurrences underwent baseline (W0-PET) and mid-treatment (W3-PET) 18F-FDG PET scans as part of their radiotherapy. FDG-PET-based metabolic volumes (MTV20%, MTV40%, MTV60%, MTV80%, SUV2.5, SUVpeak and PET_EDGE) were delineated onto the FDG-PET scans. The recurrence nidus was identified on FDG-PET at the time of recurrence (REC-PET). DIR-based fusion was performed for REC-PET to W0-PET, and REC-PET to W3-PET. The location of the recurrence nidus was correlated with the FDG-PET volumes. Further analysis included a comparison of the recurrence density to FDG-PET metabolic volumes.
Most recurrences occurred within the MTV20%, MTV40% and SUV 2.5 volumes. Sixty-nine per cent of recurrences (18 of 26) occurred within both the W0 MTV40% and W3 MTV40% volumes. A higher recurrence density was seen for iso-SUV contours closer to the maximum SUV for both W0 and W3. For a number of the FDG-PET volumes, including MTV20%, MTV40% and SUV2.5, the recurrence density was improved for W3 compared to W0, however, this improvement was small in magnitude. The average volume of MTV40% contours was considerably smaller than MTV20% and SUV2.5 contours.
The metabolic parameters of SUV2.5, MTV20% and MTV40% delineated on the baseline and mid-treatment FDG-PET scans encompassed the majority of recurrences. The MTV40% is significantly smaller, hence, we prefer this volume for future dose escalation studies.
头颈部鳞状细胞癌（HNSCC）治疗后的肿瘤复发更有可能起源于基线氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）摄取高的区域。治疗中期功能成像有可能预测更高的肿瘤复发风险。本研究的目的是将HNSCC患者在根治性放疗后局部区域肿瘤复发的位置与基线FDG-PET代谢体积和治疗中期FDG-PET代谢体积相关联。
共有23例发生26处局部和/或区域复发的患者接受了基线（W0-PET）和治疗中期（W3-PET）的18F-FDG PET扫描，作为其放疗的一部分。基于FDG-PET的代谢体积（MTV20%、MTV40%、MTV60%、MTV80%、SUV2.5、SUV峰值和PET_EDGE）在FDG-PET扫描上进行勾画。在复发时（REC-PET）通过FDG-PET确定复发灶。对REC-PET与W0-PET以及REC-PET与W3-PET进行基于DIR的融合。将复发灶的位置与FDG-PET体积相关联。进一步分析包括将复发密度与FDG-PET代谢体积进行比较。
大多数复发发生在MTV20%、MTV40%和SUV 2.5体积范围内。69%的复发（26例中的18例）发生在W0 MTV40%和W3 MTV40%体积范围内。对于W0和W3，在更接近最大SUV的等SUV轮廓处观察到更高的复发密度。对于一些FDG-PET体积，包括MTV20%、MTV40%和SUV2.5，与W0相比，W3的复发密度有所改善，然而，这种改善幅度较小。MTV40%轮廓的平均体积明显小于MTV20%和SUV2.5轮廓。
在基线和治疗中期FDG-PET扫描上勾画的SUV2.5、MTV20%和MTV40%代谢参数涵盖了大多数复发情况。MTV40%明显更小，因此，我们在未来的剂量递增研究中更倾向于使用这个体积。
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