Correlation Between FDG Hotspots on Pre-radiotherapy PET/CT and Areas of HNSCC Local Relapse: Impact of Treatment Position and Images Registration Method

Truffault, Blandine; Bourhis, David; Chaput, A; Calais, Jérémie; Robin, Philippe; Pennec, Romain Le; Lucia, François; Gujral, Dorothy M.; Véra, Pierre; Salaün, Pierre-Yves; Schick, Ulrike; Abgral, Ronan

doi:10.3389/fmed.2020.00218

Cited by 3 publications

(6 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent study including 71 HNSCC recurrences, Truffault et al showed a real benefit in the elastic registration of images especially when patients were not scanned in treatment position (NTP). Thus, using the 40%SUVmax method, the OF (A40nR40) of MTVs was significantly higher after ER than RR (p < 0.03) (46,47).…”

Section: Discussionmentioning

confidence: 89%

“…In the previous mentioned "hotspot" study, Truffault et al also showed an impact in performing pre-and post-therapeutic PET scans in the treatment position (TP) to improve the intersection between MTVs. Thus, OF (A40nR40) changed from low to moderate agreement, increasing from 0.31 ± 0.13 (NTP) to 0.50 ± 0.22 (TP) with a trend toward significance (p = 0.094) (46). On the contrary, the average DICE index evolved from strong to moderate agreement in our subgroup of MTV < 5cc, in particular with PET-Edge method (DICE = 0.44 ± 0.13).…”

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Comparison of Volumetric Quantitative PET Parameters Before and After a CT-Based Elastic Deformation on Dual-Time 18FDG-PET/CT Images: A Feasibility Study in a Perspective of Radiotherapy Planning in Head and Neck Cancer

et al. 2022

Self Cite

View full text Add to dashboard Cite

BackgroundThe use of 18FDG-PET/CT for delineating a gross tumor volume (GTV, also called MTV metabolic tumor volume) in radiotherapy (RT) planning of head neck squamous cell carcinomas (HNSCC) is not included in current recommendations, although its interest for the radiotherapist is of evidence. Because pre-RT PET scans are rarely done simultaneously with dosimetry CT, the validation of a robust image registration tool and of a reproducible MTV delineation method is still required.ObjectiveOur objective was to study a CT-based elastic registration method on dual-time pre-RT 18FDG-PET/CT images to assess the feasibility of PET-based RT planning in patients with HNSCC.MethodsDual-time 18FDG-PET/CT [whole-body examination (wbPET) + 1 dedicated step (headPET)] were selected to simulate a 2-times scenario of pre-RT PET images deformation on dosimetry CT. ER-headPET and RR-headPET images were, respectively, reconstructed after CT-to-CT rigid (RR) and elastic (ER) registrations of the headPET on the wbPET. The MTVs delineation was performed using two methods (40%SUVmax, PET-Edge). The percentage variations of several PET parameters (SUVmax, SUVmean, SUVpeak, MTV, TLG) were calculated between wbPET, ER-headPET, and RR-headPET. Correlation between MTV values was calculated (Deming linear regression). MTVs intersections were assessed by two indices (OF, DICE) and compared together (Wilcoxon test). Additional per-volume analysis was evaluated (Mann-Whitney test). Inter- and intra-observer reproducibilities were evaluated (ICC = intra-class coefficient).Results36 patients (30M/6F; median age = 65 y) were retrospectively included. The changes in SUVmax, SUVmean and SUVpeak values between ER-headPET and RR-headPET images were <5%. The variations in MTV values between ER-headPET and wbPET images were −6 and −3% with 40%SUVmax and PET Edge, respectively. Their correlations were excellent whatever the delineation method (R2 > 0.99). The ER-headPET MTVs had significant higher mean OF and DICE with the wbPET MTVs, for both delineation methods (p ≤ 0.002); and also when lesions had a volume > 5cc (excellent OF = 0.80 with 40%SUVmax). The inter- and intra-observer reproducibilities for MTV delineation were excellent (ICC ≥ 0.8, close to 1 with PET-Edge).ConclusionOur study demonstrated no significant changes in MTV after an elastic deformation of pre-RT 18FDG-PET/CT images acquired in dual-time mode. This opens possibilities for HNSCC radiotherapy planning improvement by transferring GTV-PET on dosimetry CT.

show abstract

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 94%

Comparison of Volumetric Quantitative PET Parameters Before and After a CT-Based Elastic Deformation on Dual-Time 18FDG-PET/CT Images: A Feasibility Study in a Perspective of Radiotherapy Planning in Head and Neck Cancer

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…The authors concluded that similarity between FDG hotspot on PET A and areas of local recurrence on PET R showed good to excellent agreement (ranging from 0.60 to 0.93) for lung, esophageal, and rectal carcinomas. They highlighted lower agreement for head and neck cancer, weight loss and tissue distortion after RT-CT affecting the anatomical landmarks and increasing the risk of mis-registrations [45], even if PET A and PET B were acquired in the same position and registered with an elastic method [46]. Nevertheless, no studies were reported on HGG.…”

Section: Discussionmentioning

confidence: 99%

Hotspot on 18F-FET PET/CT to Predict Aggressive Tumor Areas for Radiotherapy Dose Escalation Guiding in High-Grade Glioma

Allard

Dissaux

Bourhis

et al. 2022

Cancers

Self Cite

View full text Add to dashboard Cite

The standard therapy strategy for high-grade glioma (HGG) is based on the maximal surgery followed by radio-chemotherapy (RT-CT) with insufficient control of the disease. Recurrences are mainly localized in the radiation field, suggesting an interest in radiotherapy dose escalation to better control the disease locally. We aimed to identify a similarity between the areas of high uptake on O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) positron emission tomography/computed tomography (PET) before RT-CT, the residual tumor on post-therapy NADIR magnetic resonance imaging (MRI) and the area of recurrence on MRI. This is an ancillary study from the IMAGG prospective trial assessing the interest of FET PET imaging in RT target volume definition of HGG. We included patients with diagnoses of HGG obtained by biopsy or tumor resection. These patients underwent FET PET and brain MRIs, both after diagnosis and before RT-CT. The follow-up consisted of sequential brain MRIs performed every 3 months until recurrence. Tumor delineation on the initial MRI 1 (GTV 1), post-RT-CT NADIR MRI 2 (GTV 2), and progression MRI 3 (GTV 3) were performed semi-automatically and manually adjusted by a neuroradiologist specialist in neuro-oncology. GTV 2 and GTV 3 were then co-registered on FET PET data. Tumor volumes on FET PET (MTV) were delineated using a tumor to background ratio (TBR) ≥ 1.6 and different %SUVmax PET thresholds. Spatial similarity between different volumes was performed using the dice (DICE), Jaccard (JSC), and overlap fraction (OV) indices and compared together in the biopsy or partial surgery group (G1) and the total or subtotal surgery group (G2). Another overlap index (OV’) was calculated to determine the threshold with the highest probability of being included in the residual volume after RT-CT on MRI 2 and in MRI 3 (called “hotspot”). A total of 23 patients were included, of whom 22% (n = 5) did not have a NADIR MRI 2 due to a disease progression diagnosed on the first post-RT-CT MRI evaluation. Among the 18 patients who underwent a NADIR MRI 2, the average residual tumor was approximately 71.6% of the GTV 1. A total of 22% of patients (5/23) showed an increase in GTV 2 without diagnosis of true progression by the multidisciplinary team (MDT). Spatial similarity between MTV and GTV 2 and between MTV and GTV 3 were higher using a TBR ≥ 1.6 threshold. These indices were significantly better in the G1 group than the G2 group. In the FET hotspot analysis, the best similarity (good agreement) with GTV 2 was found in the G1 group using a 90%SUVmax delineation method and showed a trend of statistical difference with those (poor agreement) in the G2 group (OV’ = 0.67 vs. 0.38, respectively, p = 0.068); whereas the best similarity (good agreement) with GTV 3 was found in the G1 group using a 80% SUVmax delineation method and was significantly higher than those (poor agreement) in the G2 group (OV’= 0.72 vs. 0.35, respectively, p = 0.014). These results showed modest spatial similarity indices between MTV, GTV 2, and GTV 3 of HGG. Nevertheless, the results were significantly improved in patients who underwent only biopsy or partial surgery. TBR ≥ 1.6 and 80–90% SUVmax FET delineation methods showing a good agreement in the hotspot concept for targeting standard dose and radiation boost. These findings need to be tested in a larger randomized prospective study.

show abstract

“…82 Truffault et al stated that the tumour localization of hot spot uptake on PET-CT can predict local relapse of HNSCC. 83 Sensitivity and specificity of PET imaging for detecting OMs may be optimized further, for example by utilization of disease-specific radiotracers directed against tumour specific antigens. For example, 18Ffluorodihydrotestosterone, a radio-labelled dihydrotestosterone analogue, directly targets the androgen receptor on tumour cells.…”

Section: Early Screening and Detection Of Omsmentioning

confidence: 99%

“…Truffault et al . stated that the tumour localization of hot spot uptake on PET‐CT can predict local relapse of HNSCC 83 . Sensitivity and specificity of PET imaging for detecting OMs may be optimized further, for example by utilization of disease‐specific radiotracers directed against tumour specific antigens.…”

Section: Early Screening and Detection Of Omsmentioning

confidence: 99%

Oligometastases in head and neck carcinoma and their impact on management

Lazim

Elliott

Wykes

et al. 2021

ANZ Journal of Surgery

View full text Add to dashboard Cite

Historically, patients with head and neck squamous cell carcinoma (HNSCC) with distant metastases were regarded as palliative. Oligometastasis (OM) refers to patients with a limited number of distant metastatic deposits. Treatment of patients with OMs has been reported in patients with lung, colon, breast, prostate and brain malignancies. Selected patients with oligometastatic HNSCC have a higher probability of durable disease control and cure and these patients should be treated aggressively. Treatment options for patients with HNSCC OMs include single or combinations of the three arms of cancer treatment, that is surgery, radiotherapy and chemotherapy/immunotherapy. To date, there are limited studies reporting the management of OM with head and neck malignancy. This review will give insights into the management of OMs in HNSCC.

show abstract

Correlation Between FDG Hotspots on Pre-radiotherapy PET/CT and Areas of HNSCC Local Relapse: Impact of Treatment Position and Images Registration Method

Cited by 3 publications

References 54 publications

Comparison of Volumetric Quantitative PET Parameters Before and After a CT-Based Elastic Deformation on Dual-Time 18FDG-PET/CT Images: A Feasibility Study in a Perspective of Radiotherapy Planning in Head and Neck Cancer

Comparison of Volumetric Quantitative PET Parameters Before and After a CT-Based Elastic Deformation on Dual-Time 18FDG-PET/CT Images: A Feasibility Study in a Perspective of Radiotherapy Planning in Head and Neck Cancer

Hotspot on 18F-FET PET/CT to Predict Aggressive Tumor Areas for Radiotherapy Dose Escalation Guiding in High-Grade Glioma

Oligometastases in head and neck carcinoma and their impact on management

Contact Info

Product

Resources

About