FDG-PET/CT scan assessment of response 12 weeks post radical radiotherapy in oropharynx head and neck cancer: The impact of p16 status

Urban, Ryan; Godoy, Tassia; Olson, Robert; Wu, Jonn; Berthelet, Eric; Tran, Eric; DeVries, Kimberly; Wilson, Don; Hamilton, Sarah

doi:10.1016/j.radonc.2020.03.032

Cited by 18 publications

(12 citation statements)

References 26 publications

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“…Urban et al recently reported results from a similar study of 556 patients with OPSCC using an analogous dichotomized qualitative system. 27 Complete metabolic response was defined as any focal moderate/intense FDG uptake at 12 weeks. Importantly, the authors demonstrated that PET/CT specificity was inferior for PET/CTs performed within 12 weeks of radiotherapy, generally consistent with our findings and a prior meta-analysis of studies not using standardized scoring systems.…”

Section: Discussionmentioning

confidence: 99%

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Posttreatment FDG‐PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma

et al. 2022

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Background Metabolic response assessment for oropharyngeal squamous cell carcinoma (OPSCC) aids in identifying locoregional persistence/recurrence (LRR). The Hopkins Criteria are a standardized qualitative response assessment system using posttreatment FDG‐PET/CT. Methods We conducted a retrospective cohort study of patients with node‐positive OPSCC treated with definitive (chemo)radiotherapy. We assessed Hopkins Criteria performance for LRR, then developed and validated a competing‐risks model. Results Between 2004 and 2018, 259 patients were included with median follow‐up of 43 months. The Hopkins Criteria sensitivity, specificity, negative predictive value, and accuracy were 68%, 88%, 95%, and 85%. The 36‐month cumulative incidence of LRR was greater with positive scores (45% vs. 5%, HR 12.60, p < 0.001). PET/CTs performed ≤10 weeks after radiotherapy were associated with a four‐fold increase in pathologically negative biopsies/surgeries (36% vs. 9%, p = 0.03). The AUC for LRR was 0.89 using a model integrating the Hopkins score. Conclusions The Hopkins Criteria predict LRR with high accuracy for OPSCC response assessment.

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Section: Discussionmentioning

confidence: 99%

“…Urban et al recently reported results from a similar study of 556 patients with OPSCC using an analogous dichotomized qualitative system 27 . Complete metabolic response was defined as any focal moderate/intense FDG uptake at 12 weeks.…”

Section: Discussionmentioning

confidence: 99%

Posttreatment FDG‐PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma

et al. 2022

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“…The optimal time to assess RT response with nuclear medicine imaging can be challenging to determine due to the variability in inflammatory reaction and tumour response depending on the local tumour and normal tissue environment and histology of the tumour. [14][15][16] Residual avidity post-RT may not necessarily mean lack of response to RT, and premature biopsy, resection or systemic therapy may result in avoidable morbidity in patients. For instance, oropharyngeal cancer treated with RT may demonstrated delayed resolution of PET avidity, and premature neck dissections result in unnecessary morbidity without improving oncologic outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, oropharyngeal cancer treated with RT may demonstrated delayed resolution of PET avidity, and premature neck dissections result in unnecessary morbidity without improving oncologic outcomes. [15][16][17] Guidelines now recommend PET scan 3-6 months after definitive RT for oropharyngeal cancer, as earlier scans are associated with high false-positive rates. 18 Unfortunately, studies looking at the frequency of positive MIBG findings due to treatment-related inflammatory changes are lacking.…”

Section: Discussionmentioning

confidence: 99%

Time to resolution of iodine‐123 metaiodobenzylguanidine (¹²³I‐MIBG) avidity and local control outcomes for high‐risk neuroblastoma following radiation therapy

Gutkin

Wang

et al. 2022

J Med Imag Rad Onc

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Introduction: 123 I-MIBG scan is used in neuroblastoma (NB) to monitor treatment response. Time to resolution of 123 I-MIBG avidity after radiation therapy (RT) is unknown. We sought to determine time to resolution of 123 I-MIBG avidity after RT and local failure (LF) rate. Methods: We performed a retrospective review of children with high-risk NB who underwent 123 I-MIBG scans pre-and post-RT from 2003 to 2019. Time from RT to resolution of 123 I-MIBG activity was analysed. LF and cumulative incidence of local progression (CILP) after RT stratified by site, presence of residual disease and use of boost RT were determined.Results: Forty-two patients with median age 3.9 years (1.9-4.7 years) were included, with median follow-up time 3.9 years (1.4-6.9). Eighty-six lesions were treated with RT to median dose of 21.6 Gy. Eighteen of 86 lesions were evaluable for time to resolution of MIBG avidity after RT, with median resolution time of 78 days . No LF occurred among 26 patients who received RT to primary sites after GTR, versus 4/12 (25%) patients treated with residual primary disease. 2-year CILP was 19% (12% primary disease 25% metastatic disease (P = 0.18)). 2-year CILP for non-residual primary, residual primary, non-residual metastatic and residual metastatic lesions was 0%, 42%, 11% and 30% respectively (P = 0.01) and for boosted and nonboosted residual lesions was 29% and 35% (P = 0.44). Conclusion: Median time to MIBG resolution after RT was 78 days. Primary lesions without residual disease had excellent local control. LF rate was higher after RT for residual disease, with no benefit for boost RT.

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“…In these series, the reported rate of local recurrence after a CMR at the primary site ranges from 0% to 3% ( Table 1 ). In the largest of those series, Urban et al from Vancouver reported a primary negative predictive value of 100% 9 ; in other words, in their series of 648 oropharyngeal patients (556 HPV+ and 92 HPV–), there were no reported failures at the primary site in the HPV-OPC group after a CMR, with a median follow-up of 31.5 months. In that series, the predictive value was high irrespective of HPV status, a finding that has also been seen in other series.…”

mentioning

confidence: 92%

COVID-19—An Opportunity for Optimizing Surveillance Protocols During and Beyond the Pandemic: HPV-Associated Oropharyngeal Cancer as an Example of Response-Based Local Surveillance

McDowell

Corry

2020

International Journal of Radiation Oncology*Biology*Physics

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FDG-PET/CT scan assessment of response 12 weeks post radical radiotherapy in oropharynx head and neck cancer: The impact of p16 status

Cited by 18 publications

References 26 publications

Posttreatment FDG‐PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma

Posttreatment FDG‐PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma

Time to resolution of iodine‐123 metaiodobenzylguanidine (¹²³I‐MIBG) avidity and local control outcomes for high‐risk neuroblastoma following radiation therapy

COVID-19—An Opportunity for Optimizing Surveillance Protocols During and Beyond the Pandemic: HPV-Associated Oropharyngeal Cancer as an Example of Response-Based Local Surveillance

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FDG-PET/CT scan assessment of response 12 weeks post radical radiotherapy in oropharynx head and neck cancer: The impact of p16 status

Cited by 18 publications

References 26 publications

Posttreatment FDG‐PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma

Posttreatment FDG‐PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma

Time to resolution of iodine‐123 metaiodobenzylguanidine (123I‐MIBG) avidity and local control outcomes for high‐risk neuroblastoma following radiation therapy

COVID-19—An Opportunity for Optimizing Surveillance Protocols During and Beyond the Pandemic: HPV-Associated Oropharyngeal Cancer as an Example of Response-Based Local Surveillance

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Product

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Time to resolution of iodine‐123 metaiodobenzylguanidine (¹²³I‐MIBG) avidity and local control outcomes for high‐risk neuroblastoma following radiation therapy