Monitoring tumour response during chemo-radiotherapy: a parametric method using FDG-PET/CT images in patients with oesophageal cancer

Véra, Pierre; Dubray, Bernard; Palie, O.; Buvat, Irène; Hapdey, Sébastien; Modzelewski, Romain; Benyoucef, Ahmed; Rousseau, Caroline; Meyer, Marc-Étienne; Bardet, Stéphane; Gardin, I.; Fiore, Frédéric Di; Michel, Pierre

doi:10.1186/2191-219x-4-12

Cited by 19 publications

(14 citation statements)

References 37 publications

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“…Comparisons between cancer metabolism revealed by PET-CT before and after treatments enables evaluation of responses to treatments (6,24,25). Previous studies reported that decreases of standardized uptake value in tumors evaluated by PET-CT after preoperative chemoradiotherapy were associated with histopathological tumor responses (26,27). Moreover, PET-CT performed after CRT predicted the prognoses of patients with primary or postoperative recurrent EC (28,29).…”

Section: Discussionmentioning

confidence: 99%

Efficacy of PET-CT in the Diagnosis and Treatment of Recurrence After Esophageal Cancer Surgery

Kudou

Shiozaki

Fujiwara

et al. 2016

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Abstract. Aim The present study aimed to retrospectively investigate the utility of positron-emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose integrated with computed tomography (PET-CT) in regular followEsophageal cancer (EC) is the eighth most common cancer worldwide, with an estimated 456,000 new cases in 2012 (3.2% of all cases), and the sixth most common cause of death from cancer, with an estimated 400,000 deaths (4.9% of all deaths)(1). Although several diagnostic modalities and multimodal therapies have been developed in recent years, the prognosis of patients with EC remains poor even when curative surgery is performed. Postoperative recurrence occurs in 78% of patients who undergo curative surgery for EC (2, 3). Recurrence of EC is regarded as a grave prognostic sign after curative surgery, with most patients dying due to the progression of their cancer. However, a few patients with postoperative recurrence have achieved long-term survival (4, 5). The development of more effective therapies or examinations is presumed to have improved the clinical outcomes of patients with recurrent EC. In order to achieve further improvements in the prognosis of these patients, the characteristics of recurrent cases that survive long-term, and prognostic factors for recurrent EC need to be elucidated in more detail.Positron-emission tomography with 2-deoxy-2-[fluorine-18]fluoro-D-glucose, an analog of glucose, integrated with computed tomography (PET-CT) is a functional imaging technique based on increased glucose uptake and glycolysis by cancer cells. In Japan, EC was approved as an indication for the use of PET-CT under health insurance coverage in April 2006. PET-CT is now widely used and provides a sensitive and specific examination for the staging or diagnosis of recurrent lesions in various lips of cancer (6-8). Furthermore, a previous study showed that PET-CT was useful for the early detection of recurrence after esophagostomy, and contributed to a good prognosis through early detection of single recurrent tumors (5). Although the utility of PET-CT in EC has been reported, an appropriate method for applying PET-CT to follow-up after curative surgery for EC has not yet been established. In order to provide EC patients the best medical care, it is necessary to clarify the utility of PET-CT in postoperative follow-up.PET-CT was implemented at our Institution in March 2007. We have been conducting imaging observations for regular follow-up of patients who underwent curative surgery for EC in our Division using PET-CT since January 2008. The present study aimed to retrospectively investigate the 5473

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Section: Discussionmentioning

confidence: 99%

Efficacy of PET-CT in the Diagnosis and Treatment of Recurrence After Esophageal Cancer Surgery

Kudou

Shiozaki

Fujiwara

et al. 2016

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“…Evaluation of relative changes on a voxel level is unreliable for tumor subvolumes with a very low baseline PET value, for which relative changes may be high despite both baseline and posttherapy PET image values within the background range. Evaluation of absolute change in PET values on a voxel level (129,130) might be less sensitive to cases of very low baseline PET values. An evaluation of the therapeutic response on a voxel level is also strongly affected by the selection of registration algorithm (131).…”

Section: Spatially Resolved Treatment Response Evaluationmentioning

confidence: 99%

“…An obvious approach to incorporate the intratumoral heterogeneity into treatment response would be to evaluate spatial therapeutic response. Therapeutic response can be evaluated at a voxel level as absolute change in the PET values (129,130) or as relative change from the baseline image (131). Evaluation of relative changes on a voxel level is unreliable for tumor subvolumes with a very low baseline PET value, for which relative changes may be high despite both baseline and posttherapy PET image values within the background range.…”

Section: Spatially Resolved Treatment Response Evaluationmentioning

confidence: 99%

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

2015

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) how to acquire high-quality molecular images for use in radiation therapy; (2) how molecular imaging can be used to plan radiotherapy and evaluate treatment efficacy; and (3) the limitations and challenges to widespread use of molecular imaging in radiation oncology.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through November 2018.Molecular imaging plays a central role in the management of radiation oncology patients. Specific uses of imaging, particularly to plan radiotherapy and assess its efficacy, require an additional level of reproducibility and image quality beyond what is required for diagnostic imaging. Specific requirements include proper patient preparation, adequate technologist training, careful imaging protocol design, reliable scanner technology, reproducible software algorithms, and reliable data analysis methods. As uncertainty in target definition is arguably the greatest challenge facing radiation oncology, the greatest impact that molecular imaging can have may be in the reduction of interobserver variability in target volume delineation and in providing greater conformity between target volume boundaries and true tumor boundaries. Several automatic and semiautomatic contouring methods based on molecular imaging are available but still need sufficient validation to be widely adopted. Biologically conformal radiotherapy (dose painting) based on molecular imaging-assessed tumor heterogeneity is being investigated, but many challenges remain to fully exploring its potential. Molecular imaging also plays increasingly important roles in both early (during treatment) and late (after treatment) response assessment as both a predictive and a prognostic tool. Because of potentially confounding effects of radiation-induced inflammation, treatment response assessment requires careful interpretation. Although molecular imaging is already strongly embedded in radiotherapy, the path to widespread and all-inclusive use is still long. The lack of solid clinical evidence is the main impediment to broader use. Recommendations for practicing physicians are still rather scarce. 18 F-FDG PET/CT remains the main molecular imaging modality in radiation oncology applications. Although other molecular imaging options (e.g., proliferation imaging) are becoming more common, their widespread use is limited ...

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“…It preserves the topology of the anatomical structures by allowing only rotations and translations in the transformation. Although rigid registration is straightforward, it has been shown to achieve good alignment between baseline and evaluation scans in tumour response assessment studies 12,[16][17][18][19] (Table 1). Necib et al 12 reported their study in metastatic colorectal tumour response assessment using PET/CT scans acquired before and during CTx.…”

Section: Rigid Registrationmentioning

confidence: 99%

“…The changes of comprehensive spatial temporal features from 18 F-FDG-PET scans were found to be useful for the assessment of response to CRT. Vera et al 19 applied similar rigid registration to align baseline and mid-therapy 18 F-FDG-PET/CT scans to monitor the early tumour metabolic response to CRT of patients with oesophageal cancer. The results showed that the changes in 18 F-FDG uptakes provided prognostic information for the early tumour metabolic response.…”

Section: Rigid Registrationmentioning

confidence: 99%

Computerized PET/CT image analysis in the evaluation of tumour response to therapy

Wang²,

Zhang³

2015

BJR

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Current cancer therapy strategy is mostly population based, however, there are large differences in tumour response among patients. It is therefore important for treating physicians to know individual tumour response. In recent years, many studies proposed the use of computerized positron emission tomography/CT image analysis in the evaluation of tumour response. Results showed that computerized analysis overcame some major limitations of current qualitative and semiquantitative analysis and led to improved accuracy. In this review, we summarize these studies in four steps of the analysis: image registration, tumour segmentation, image feature extraction and response evaluation. Future works are proposed and challenges described.

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Monitoring tumour response during chemo-radiotherapy: a parametric method using FDG-PET/CT images in patients with oesophageal cancer

Cited by 19 publications

References 37 publications

Efficacy of PET-CT in the Diagnosis and Treatment of Recurrence After Esophageal Cancer Surgery

Efficacy of PET-CT in the Diagnosis and Treatment of Recurrence After Esophageal Cancer Surgery

Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy

Computerized PET/CT image analysis in the evaluation of tumour response to therapy

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