PET measured hypoxia and MRI parameters in re-irradiated head and neck squamous cell carcinomas: findings of a prospective pilot study [version 2; peer review: 2 approved]
Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography...
Ausführliche Beschreibung
Autor*in: |
Julian Rogasch [verfasserIn] Marcus Beck [verfasserIn] Carmen Stromberger [verfasserIn] Frank Hofheinz [verfasserIn] Pirus Ghadjar [verfasserIn] Peter Wust [verfasserIn] Volker Budach [verfasserIn] Holger Amthauer [verfasserIn] Ingeborg Tinhofer [verfasserIn] Christian Furth [verfasserIn] Thula C. Walter-Rittel [verfasserIn] Sebastian Zschaeck [verfasserIn] |
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E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2021 |
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Übergeordnetes Werk: |
In: F1000Research - F1000 Research Ltd, 2013, 9(2021) |
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Übergeordnetes Werk: |
volume:9 ; year:2021 |
Links: |
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DOI / URN: |
10.12688/f1000research.27303.2 |
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Katalog-ID: |
DOAJ057296960 |
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520 | |a Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography (PET) measured hypoxia in patients with relapse after previous irradiation is missing. Here we report imaging findings of a prospective pilot study in HNSCC patients treated with re-irradiation. Methods: In 8 patients with recurrent HNSCC, diagnosed at a median of 18 months after initial radiotherapy/CRT, [18F]fluorodeoxyglucose (FDG)-PET/CT (n=8) and FMISO-PET/MRI (n=7) or FMISO-PET/CT (n=1) were performed. Static FMISO-PET was performed after 180 min. MRI sequences in PET/MRI included diffusion-weighted imaging with apparent diffusion coefficient (ADC) values and contrast enhanced T1w imaging (StarVIBE). Lesions (primary tumor recurrence, 4; cervical lymph node, 1; both, 3) were delineated on FDG-PET and FMISO-PET data using a background-adapted threshold-based method. SUVmax and SUVmean in FDG- and FMISO-PET were derived, as well as maximum tumor-to-muscle ratio (TMRmax) and hypoxic volume with 1.6-fold muscle SUVmean (HV1.6) in FMISO-PET. Intensity of lesional contrast enhancement was rated relative to contralateral normal tissue. Average ADC values were derived from a 2D region of interest in the tumor. Results: In FMISO-PET, median TMRmax was 1.7 (range: 1.1-1.8). Median HV1.6 was 0.05 ml (range: 0-7.3 ml). Only in 2/8 patients, HV1.6 was ≥1.0 ml. In FDG-PET, median SUVmax was 9.3 (range: 5.0-20.1). On contrast enhanced imaging four lesions showed decreased and four lesions increased contrast enhancement compared to non-pathologic reference tissue. Median average ADC was 1,060 ×106 mm2/s (range: 840-1,400 ×106 mm2/s). Conclusions: This pilot study implies that hypoxia detectable by FMISO-PET may not be as prevalent as expected among loco-regional recurrent, HPV negative HNSCC. ADC values were only mildly reduced, and contrast enhancement was variable. The results require confirmation in larger sample sizes. | ||
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10.12688/f1000research.27303.2 doi (DE-627)DOAJ057296960 (DE-599)DOAJ891c5c0967b54f0387980ff533043223 DE-627 ger DE-627 rakwb eng Julian Rogasch verfasserin aut PET measured hypoxia and MRI parameters in re-irradiated head and neck squamous cell carcinomas: findings of a prospective pilot study [version 2; peer review: 2 approved] 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography (PET) measured hypoxia in patients with relapse after previous irradiation is missing. Here we report imaging findings of a prospective pilot study in HNSCC patients treated with re-irradiation. Methods: In 8 patients with recurrent HNSCC, diagnosed at a median of 18 months after initial radiotherapy/CRT, [18F]fluorodeoxyglucose (FDG)-PET/CT (n=8) and FMISO-PET/MRI (n=7) or FMISO-PET/CT (n=1) were performed. Static FMISO-PET was performed after 180 min. MRI sequences in PET/MRI included diffusion-weighted imaging with apparent diffusion coefficient (ADC) values and contrast enhanced T1w imaging (StarVIBE). Lesions (primary tumor recurrence, 4; cervical lymph node, 1; both, 3) were delineated on FDG-PET and FMISO-PET data using a background-adapted threshold-based method. SUVmax and SUVmean in FDG- and FMISO-PET were derived, as well as maximum tumor-to-muscle ratio (TMRmax) and hypoxic volume with 1.6-fold muscle SUVmean (HV1.6) in FMISO-PET. Intensity of lesional contrast enhancement was rated relative to contralateral normal tissue. Average ADC values were derived from a 2D region of interest in the tumor. Results: In FMISO-PET, median TMRmax was 1.7 (range: 1.1-1.8). Median HV1.6 was 0.05 ml (range: 0-7.3 ml). Only in 2/8 patients, HV1.6 was ≥1.0 ml. In FDG-PET, median SUVmax was 9.3 (range: 5.0-20.1). On contrast enhanced imaging four lesions showed decreased and four lesions increased contrast enhancement compared to non-pathologic reference tissue. Median average ADC was 1,060 ×106 mm2/s (range: 840-1,400 ×106 mm2/s). Conclusions: This pilot study implies that hypoxia detectable by FMISO-PET may not be as prevalent as expected among loco-regional recurrent, HPV negative HNSCC. ADC values were only mildly reduced, and contrast enhancement was variable. The results require confirmation in larger sample sizes. Medicine R Science Q Marcus Beck verfasserin aut Carmen Stromberger verfasserin aut Frank Hofheinz verfasserin aut Pirus Ghadjar verfasserin aut Peter Wust verfasserin aut Volker Budach verfasserin aut Holger Amthauer verfasserin aut Ingeborg Tinhofer verfasserin aut Christian Furth verfasserin aut Thula C. Walter-Rittel verfasserin aut Sebastian Zschaeck verfasserin aut In F1000Research F1000 Research Ltd, 2013 9(2021) (DE-627)735133581 (DE-600)2699932-8 20461402 nnns volume:9 year:2021 https://doi.org/10.12688/f1000research.27303.2 kostenfrei https://doaj.org/article/891c5c0967b54f0387980ff533043223 kostenfrei https://f1000research.com/articles/9-1350/v2 kostenfrei https://doaj.org/toc/2046-1402 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021 |
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10.12688/f1000research.27303.2 doi (DE-627)DOAJ057296960 (DE-599)DOAJ891c5c0967b54f0387980ff533043223 DE-627 ger DE-627 rakwb eng Julian Rogasch verfasserin aut PET measured hypoxia and MRI parameters in re-irradiated head and neck squamous cell carcinomas: findings of a prospective pilot study [version 2; peer review: 2 approved] 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography (PET) measured hypoxia in patients with relapse after previous irradiation is missing. Here we report imaging findings of a prospective pilot study in HNSCC patients treated with re-irradiation. Methods: In 8 patients with recurrent HNSCC, diagnosed at a median of 18 months after initial radiotherapy/CRT, [18F]fluorodeoxyglucose (FDG)-PET/CT (n=8) and FMISO-PET/MRI (n=7) or FMISO-PET/CT (n=1) were performed. Static FMISO-PET was performed after 180 min. MRI sequences in PET/MRI included diffusion-weighted imaging with apparent diffusion coefficient (ADC) values and contrast enhanced T1w imaging (StarVIBE). Lesions (primary tumor recurrence, 4; cervical lymph node, 1; both, 3) were delineated on FDG-PET and FMISO-PET data using a background-adapted threshold-based method. SUVmax and SUVmean in FDG- and FMISO-PET were derived, as well as maximum tumor-to-muscle ratio (TMRmax) and hypoxic volume with 1.6-fold muscle SUVmean (HV1.6) in FMISO-PET. Intensity of lesional contrast enhancement was rated relative to contralateral normal tissue. Average ADC values were derived from a 2D region of interest in the tumor. Results: In FMISO-PET, median TMRmax was 1.7 (range: 1.1-1.8). Median HV1.6 was 0.05 ml (range: 0-7.3 ml). Only in 2/8 patients, HV1.6 was ≥1.0 ml. In FDG-PET, median SUVmax was 9.3 (range: 5.0-20.1). On contrast enhanced imaging four lesions showed decreased and four lesions increased contrast enhancement compared to non-pathologic reference tissue. Median average ADC was 1,060 ×106 mm2/s (range: 840-1,400 ×106 mm2/s). Conclusions: This pilot study implies that hypoxia detectable by FMISO-PET may not be as prevalent as expected among loco-regional recurrent, HPV negative HNSCC. ADC values were only mildly reduced, and contrast enhancement was variable. The results require confirmation in larger sample sizes. Medicine R Science Q Marcus Beck verfasserin aut Carmen Stromberger verfasserin aut Frank Hofheinz verfasserin aut Pirus Ghadjar verfasserin aut Peter Wust verfasserin aut Volker Budach verfasserin aut Holger Amthauer verfasserin aut Ingeborg Tinhofer verfasserin aut Christian Furth verfasserin aut Thula C. Walter-Rittel verfasserin aut Sebastian Zschaeck verfasserin aut In F1000Research F1000 Research Ltd, 2013 9(2021) (DE-627)735133581 (DE-600)2699932-8 20461402 nnns volume:9 year:2021 https://doi.org/10.12688/f1000research.27303.2 kostenfrei https://doaj.org/article/891c5c0967b54f0387980ff533043223 kostenfrei https://f1000research.com/articles/9-1350/v2 kostenfrei https://doaj.org/toc/2046-1402 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021 |
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10.12688/f1000research.27303.2 doi (DE-627)DOAJ057296960 (DE-599)DOAJ891c5c0967b54f0387980ff533043223 DE-627 ger DE-627 rakwb eng Julian Rogasch verfasserin aut PET measured hypoxia and MRI parameters in re-irradiated head and neck squamous cell carcinomas: findings of a prospective pilot study [version 2; peer review: 2 approved] 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography (PET) measured hypoxia in patients with relapse after previous irradiation is missing. Here we report imaging findings of a prospective pilot study in HNSCC patients treated with re-irradiation. Methods: In 8 patients with recurrent HNSCC, diagnosed at a median of 18 months after initial radiotherapy/CRT, [18F]fluorodeoxyglucose (FDG)-PET/CT (n=8) and FMISO-PET/MRI (n=7) or FMISO-PET/CT (n=1) were performed. Static FMISO-PET was performed after 180 min. MRI sequences in PET/MRI included diffusion-weighted imaging with apparent diffusion coefficient (ADC) values and contrast enhanced T1w imaging (StarVIBE). Lesions (primary tumor recurrence, 4; cervical lymph node, 1; both, 3) were delineated on FDG-PET and FMISO-PET data using a background-adapted threshold-based method. SUVmax and SUVmean in FDG- and FMISO-PET were derived, as well as maximum tumor-to-muscle ratio (TMRmax) and hypoxic volume with 1.6-fold muscle SUVmean (HV1.6) in FMISO-PET. Intensity of lesional contrast enhancement was rated relative to contralateral normal tissue. Average ADC values were derived from a 2D region of interest in the tumor. Results: In FMISO-PET, median TMRmax was 1.7 (range: 1.1-1.8). Median HV1.6 was 0.05 ml (range: 0-7.3 ml). Only in 2/8 patients, HV1.6 was ≥1.0 ml. In FDG-PET, median SUVmax was 9.3 (range: 5.0-20.1). On contrast enhanced imaging four lesions showed decreased and four lesions increased contrast enhancement compared to non-pathologic reference tissue. Median average ADC was 1,060 ×106 mm2/s (range: 840-1,400 ×106 mm2/s). Conclusions: This pilot study implies that hypoxia detectable by FMISO-PET may not be as prevalent as expected among loco-regional recurrent, HPV negative HNSCC. ADC values were only mildly reduced, and contrast enhancement was variable. The results require confirmation in larger sample sizes. Medicine R Science Q Marcus Beck verfasserin aut Carmen Stromberger verfasserin aut Frank Hofheinz verfasserin aut Pirus Ghadjar verfasserin aut Peter Wust verfasserin aut Volker Budach verfasserin aut Holger Amthauer verfasserin aut Ingeborg Tinhofer verfasserin aut Christian Furth verfasserin aut Thula C. Walter-Rittel verfasserin aut Sebastian Zschaeck verfasserin aut In F1000Research F1000 Research Ltd, 2013 9(2021) (DE-627)735133581 (DE-600)2699932-8 20461402 nnns volume:9 year:2021 https://doi.org/10.12688/f1000research.27303.2 kostenfrei https://doaj.org/article/891c5c0967b54f0387980ff533043223 kostenfrei https://f1000research.com/articles/9-1350/v2 kostenfrei https://doaj.org/toc/2046-1402 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021 |
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10.12688/f1000research.27303.2 doi (DE-627)DOAJ057296960 (DE-599)DOAJ891c5c0967b54f0387980ff533043223 DE-627 ger DE-627 rakwb eng Julian Rogasch verfasserin aut PET measured hypoxia and MRI parameters in re-irradiated head and neck squamous cell carcinomas: findings of a prospective pilot study [version 2; peer review: 2 approved] 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography (PET) measured hypoxia in patients with relapse after previous irradiation is missing. Here we report imaging findings of a prospective pilot study in HNSCC patients treated with re-irradiation. Methods: In 8 patients with recurrent HNSCC, diagnosed at a median of 18 months after initial radiotherapy/CRT, [18F]fluorodeoxyglucose (FDG)-PET/CT (n=8) and FMISO-PET/MRI (n=7) or FMISO-PET/CT (n=1) were performed. Static FMISO-PET was performed after 180 min. MRI sequences in PET/MRI included diffusion-weighted imaging with apparent diffusion coefficient (ADC) values and contrast enhanced T1w imaging (StarVIBE). Lesions (primary tumor recurrence, 4; cervical lymph node, 1; both, 3) were delineated on FDG-PET and FMISO-PET data using a background-adapted threshold-based method. SUVmax and SUVmean in FDG- and FMISO-PET were derived, as well as maximum tumor-to-muscle ratio (TMRmax) and hypoxic volume with 1.6-fold muscle SUVmean (HV1.6) in FMISO-PET. Intensity of lesional contrast enhancement was rated relative to contralateral normal tissue. Average ADC values were derived from a 2D region of interest in the tumor. Results: In FMISO-PET, median TMRmax was 1.7 (range: 1.1-1.8). Median HV1.6 was 0.05 ml (range: 0-7.3 ml). Only in 2/8 patients, HV1.6 was ≥1.0 ml. In FDG-PET, median SUVmax was 9.3 (range: 5.0-20.1). On contrast enhanced imaging four lesions showed decreased and four lesions increased contrast enhancement compared to non-pathologic reference tissue. Median average ADC was 1,060 ×106 mm2/s (range: 840-1,400 ×106 mm2/s). Conclusions: This pilot study implies that hypoxia detectable by FMISO-PET may not be as prevalent as expected among loco-regional recurrent, HPV negative HNSCC. ADC values were only mildly reduced, and contrast enhancement was variable. The results require confirmation in larger sample sizes. Medicine R Science Q Marcus Beck verfasserin aut Carmen Stromberger verfasserin aut Frank Hofheinz verfasserin aut Pirus Ghadjar verfasserin aut Peter Wust verfasserin aut Volker Budach verfasserin aut Holger Amthauer verfasserin aut Ingeborg Tinhofer verfasserin aut Christian Furth verfasserin aut Thula C. Walter-Rittel verfasserin aut Sebastian Zschaeck verfasserin aut In F1000Research F1000 Research Ltd, 2013 9(2021) (DE-627)735133581 (DE-600)2699932-8 20461402 nnns volume:9 year:2021 https://doi.org/10.12688/f1000research.27303.2 kostenfrei https://doaj.org/article/891c5c0967b54f0387980ff533043223 kostenfrei https://f1000research.com/articles/9-1350/v2 kostenfrei https://doaj.org/toc/2046-1402 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021 |
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10.12688/f1000research.27303.2 doi (DE-627)DOAJ057296960 (DE-599)DOAJ891c5c0967b54f0387980ff533043223 DE-627 ger DE-627 rakwb eng Julian Rogasch verfasserin aut PET measured hypoxia and MRI parameters in re-irradiated head and neck squamous cell carcinomas: findings of a prospective pilot study [version 2; peer review: 2 approved] 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography (PET) measured hypoxia in patients with relapse after previous irradiation is missing. Here we report imaging findings of a prospective pilot study in HNSCC patients treated with re-irradiation. Methods: In 8 patients with recurrent HNSCC, diagnosed at a median of 18 months after initial radiotherapy/CRT, [18F]fluorodeoxyglucose (FDG)-PET/CT (n=8) and FMISO-PET/MRI (n=7) or FMISO-PET/CT (n=1) were performed. Static FMISO-PET was performed after 180 min. MRI sequences in PET/MRI included diffusion-weighted imaging with apparent diffusion coefficient (ADC) values and contrast enhanced T1w imaging (StarVIBE). Lesions (primary tumor recurrence, 4; cervical lymph node, 1; both, 3) were delineated on FDG-PET and FMISO-PET data using a background-adapted threshold-based method. SUVmax and SUVmean in FDG- and FMISO-PET were derived, as well as maximum tumor-to-muscle ratio (TMRmax) and hypoxic volume with 1.6-fold muscle SUVmean (HV1.6) in FMISO-PET. Intensity of lesional contrast enhancement was rated relative to contralateral normal tissue. Average ADC values were derived from a 2D region of interest in the tumor. Results: In FMISO-PET, median TMRmax was 1.7 (range: 1.1-1.8). Median HV1.6 was 0.05 ml (range: 0-7.3 ml). Only in 2/8 patients, HV1.6 was ≥1.0 ml. In FDG-PET, median SUVmax was 9.3 (range: 5.0-20.1). On contrast enhanced imaging four lesions showed decreased and four lesions increased contrast enhancement compared to non-pathologic reference tissue. Median average ADC was 1,060 ×106 mm2/s (range: 840-1,400 ×106 mm2/s). Conclusions: This pilot study implies that hypoxia detectable by FMISO-PET may not be as prevalent as expected among loco-regional recurrent, HPV negative HNSCC. ADC values were only mildly reduced, and contrast enhancement was variable. The results require confirmation in larger sample sizes. Medicine R Science Q Marcus Beck verfasserin aut Carmen Stromberger verfasserin aut Frank Hofheinz verfasserin aut Pirus Ghadjar verfasserin aut Peter Wust verfasserin aut Volker Budach verfasserin aut Holger Amthauer verfasserin aut Ingeborg Tinhofer verfasserin aut Christian Furth verfasserin aut Thula C. Walter-Rittel verfasserin aut Sebastian Zschaeck verfasserin aut In F1000Research F1000 Research Ltd, 2013 9(2021) (DE-627)735133581 (DE-600)2699932-8 20461402 nnns volume:9 year:2021 https://doi.org/10.12688/f1000research.27303.2 kostenfrei https://doaj.org/article/891c5c0967b54f0387980ff533043223 kostenfrei https://f1000research.com/articles/9-1350/v2 kostenfrei https://doaj.org/toc/2046-1402 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2021 |
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PET measured hypoxia and MRI parameters in re-irradiated head and neck squamous cell carcinomas: findings of a prospective pilot study [version 2; peer review: 2 approved] |
abstract |
Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography (PET) measured hypoxia in patients with relapse after previous irradiation is missing. Here we report imaging findings of a prospective pilot study in HNSCC patients treated with re-irradiation. Methods: In 8 patients with recurrent HNSCC, diagnosed at a median of 18 months after initial radiotherapy/CRT, [18F]fluorodeoxyglucose (FDG)-PET/CT (n=8) and FMISO-PET/MRI (n=7) or FMISO-PET/CT (n=1) were performed. Static FMISO-PET was performed after 180 min. MRI sequences in PET/MRI included diffusion-weighted imaging with apparent diffusion coefficient (ADC) values and contrast enhanced T1w imaging (StarVIBE). Lesions (primary tumor recurrence, 4; cervical lymph node, 1; both, 3) were delineated on FDG-PET and FMISO-PET data using a background-adapted threshold-based method. SUVmax and SUVmean in FDG- and FMISO-PET were derived, as well as maximum tumor-to-muscle ratio (TMRmax) and hypoxic volume with 1.6-fold muscle SUVmean (HV1.6) in FMISO-PET. Intensity of lesional contrast enhancement was rated relative to contralateral normal tissue. Average ADC values were derived from a 2D region of interest in the tumor. Results: In FMISO-PET, median TMRmax was 1.7 (range: 1.1-1.8). Median HV1.6 was 0.05 ml (range: 0-7.3 ml). Only in 2/8 patients, HV1.6 was ≥1.0 ml. In FDG-PET, median SUVmax was 9.3 (range: 5.0-20.1). On contrast enhanced imaging four lesions showed decreased and four lesions increased contrast enhancement compared to non-pathologic reference tissue. Median average ADC was 1,060 ×106 mm2/s (range: 840-1,400 ×106 mm2/s). Conclusions: This pilot study implies that hypoxia detectable by FMISO-PET may not be as prevalent as expected among loco-regional recurrent, HPV negative HNSCC. ADC values were only mildly reduced, and contrast enhancement was variable. The results require confirmation in larger sample sizes. |
abstractGer |
Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography (PET) measured hypoxia in patients with relapse after previous irradiation is missing. Here we report imaging findings of a prospective pilot study in HNSCC patients treated with re-irradiation. Methods: In 8 patients with recurrent HNSCC, diagnosed at a median of 18 months after initial radiotherapy/CRT, [18F]fluorodeoxyglucose (FDG)-PET/CT (n=8) and FMISO-PET/MRI (n=7) or FMISO-PET/CT (n=1) were performed. Static FMISO-PET was performed after 180 min. MRI sequences in PET/MRI included diffusion-weighted imaging with apparent diffusion coefficient (ADC) values and contrast enhanced T1w imaging (StarVIBE). Lesions (primary tumor recurrence, 4; cervical lymph node, 1; both, 3) were delineated on FDG-PET and FMISO-PET data using a background-adapted threshold-based method. SUVmax and SUVmean in FDG- and FMISO-PET were derived, as well as maximum tumor-to-muscle ratio (TMRmax) and hypoxic volume with 1.6-fold muscle SUVmean (HV1.6) in FMISO-PET. Intensity of lesional contrast enhancement was rated relative to contralateral normal tissue. Average ADC values were derived from a 2D region of interest in the tumor. Results: In FMISO-PET, median TMRmax was 1.7 (range: 1.1-1.8). Median HV1.6 was 0.05 ml (range: 0-7.3 ml). Only in 2/8 patients, HV1.6 was ≥1.0 ml. In FDG-PET, median SUVmax was 9.3 (range: 5.0-20.1). On contrast enhanced imaging four lesions showed decreased and four lesions increased contrast enhancement compared to non-pathologic reference tissue. Median average ADC was 1,060 ×106 mm2/s (range: 840-1,400 ×106 mm2/s). Conclusions: This pilot study implies that hypoxia detectable by FMISO-PET may not be as prevalent as expected among loco-regional recurrent, HPV negative HNSCC. ADC values were only mildly reduced, and contrast enhancement was variable. The results require confirmation in larger sample sizes. |
abstract_unstemmed |
Background: Tumor hypoxia measured by dedicated tracers like [18F]fluoromisonidazole (FMISO) is a well-established prognostic factor in head and neck squamous cell carcinomas (HNSCC) treated with definitive chemoradiation (CRT). However, prevalence and characteristics of positron emission tomography (PET) measured hypoxia in patients with relapse after previous irradiation is missing. Here we report imaging findings of a prospective pilot study in HNSCC patients treated with re-irradiation. Methods: In 8 patients with recurrent HNSCC, diagnosed at a median of 18 months after initial radiotherapy/CRT, [18F]fluorodeoxyglucose (FDG)-PET/CT (n=8) and FMISO-PET/MRI (n=7) or FMISO-PET/CT (n=1) were performed. Static FMISO-PET was performed after 180 min. MRI sequences in PET/MRI included diffusion-weighted imaging with apparent diffusion coefficient (ADC) values and contrast enhanced T1w imaging (StarVIBE). Lesions (primary tumor recurrence, 4; cervical lymph node, 1; both, 3) were delineated on FDG-PET and FMISO-PET data using a background-adapted threshold-based method. SUVmax and SUVmean in FDG- and FMISO-PET were derived, as well as maximum tumor-to-muscle ratio (TMRmax) and hypoxic volume with 1.6-fold muscle SUVmean (HV1.6) in FMISO-PET. Intensity of lesional contrast enhancement was rated relative to contralateral normal tissue. Average ADC values were derived from a 2D region of interest in the tumor. Results: In FMISO-PET, median TMRmax was 1.7 (range: 1.1-1.8). Median HV1.6 was 0.05 ml (range: 0-7.3 ml). Only in 2/8 patients, HV1.6 was ≥1.0 ml. In FDG-PET, median SUVmax was 9.3 (range: 5.0-20.1). On contrast enhanced imaging four lesions showed decreased and four lesions increased contrast enhancement compared to non-pathologic reference tissue. Median average ADC was 1,060 ×106 mm2/s (range: 840-1,400 ×106 mm2/s). Conclusions: This pilot study implies that hypoxia detectable by FMISO-PET may not be as prevalent as expected among loco-regional recurrent, HPV negative HNSCC. ADC values were only mildly reduced, and contrast enhancement was variable. The results require confirmation in larger sample sizes. |
collection_details |
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title_short |
PET measured hypoxia and MRI parameters in re-irradiated head and neck squamous cell carcinomas: findings of a prospective pilot study [version 2; peer review: 2 approved] |
url |
https://doi.org/10.12688/f1000research.27303.2 https://doaj.org/article/891c5c0967b54f0387980ff533043223 https://f1000research.com/articles/9-1350/v2 https://doaj.org/toc/2046-1402 |
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Marcus Beck Carmen Stromberger Frank Hofheinz Pirus Ghadjar Peter Wust Volker Budach Holger Amthauer Ingeborg Tinhofer Christian Furth Thula C. Walter-Rittel Sebastian Zschaeck |
author2Str |
Marcus Beck Carmen Stromberger Frank Hofheinz Pirus Ghadjar Peter Wust Volker Budach Holger Amthauer Ingeborg Tinhofer Christian Furth Thula C. Walter-Rittel Sebastian Zschaeck |
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up_date |
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