Positron Emission Tomography-Guided, Focal-Dose Escalation Using Intensity-Modulated Radiotherapy for Head and Neck Cancer

Madani, Indira; Duthoy, Wim; Derie, C.; Gersem, Werner De; Boterberg, Tom; Saerens, Michael; Jacobs, Filip; Grégoire, Vincent; Lonneux, Max; Vakaet, Luc; Vanderstraeten, Barbara; Bauters, Wouter; Bonte, Katrien; Thierens, Hubert; Neve, Wilfried De

doi:10.1016/j.ijrobp.2006.12.070

Cited by 195 publications

(158 citation statements)

References 25 publications

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“…Given that we observed one of nine LRF (11%, 95% CI: 3-45%) outside the PETBTV, the confidence intervals suggest that if the GTVs are based solely on FDGPET, under treatment could occur in up to 45% of patients. Madani and colleagues have recently reported similar findings with 33% (3/9) LRF outside the PET-BTV [24]. Both our series and Madani's likely underestimate the true risk of failures outside the PET-BTV as all patients in these series had GTVs defined beyond the PET-BTV.…”

Section: Discussionsupporting

confidence: 84%

“…PET defined BTVs may be an area that warrants augmented therapy, such as RT boost dose escalation [6,24,29]. At this time we do not know if higher RT doses to these targets could improve failure rates and outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…However, our data supports the need to explore this as the majority of failures mapped to the pretreatment PET abnormality. Others have previously shown that dose escalation of the PET abnormality is feasible in select patients [24,30,31]. Such areas could be part of a simultaneous integrated boost [32,33].…”

Section: Discussionmentioning

confidence: 99%

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Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Soto¹,

Kessler²,

Piert³

et al. 2008

Radiotherapy and Oncology

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Soto¹,

Kessler²,

Piert³

et al. 2008

Radiotherapy and Oncology

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“…Our data confirmed the potential value of 18 F-FDG PET/ CT for target volume delineation in patients with HNSCC (4)(5)(6)(7)(8). Although the GTV FDG , based on a validated sourceto-background algorithm, was significantly smaller than the anatomic tumor volume on CT, all locoregional failures occurred within the initial 18 F-FDG-avid volume.…”

Section: Discussionsupporting

confidence: 79%

“…In HNSCC, 18 F-FDG PET has a clear impact on both primary tumor delineation and cervical lymph node staging (5,6). Results from several trials suggest that pretreatment 18 F-FDG uptake correlates with outcome in HNSCC patients and can therefore indicate a valuable target for dose escalation (7,8).…”

mentioning

confidence: 99%

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Dirix¹,

Vandecaveye²,

Keyzer³

et al. 2009

J Nucl Med

194

109

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The purpose of this work was to evaluate the potential of functional imaging with 18 F-FDG PET, 18 F-fluoromisonidazole PET, diffusion-weighted MRI, and dynamic contrast-enhanced MRI to provide an appropriate and reliable biologic target for dose painting in radiotherapy for head and neck squamous cell carcinoma (HNSCC). Methods: Fifteen patients with locally advanced HNSCC, treated with concomitant chemoradiotherapy, were prospectively enrolled in a bioimaging protocol. Sequential PET ( 18 F-FDG and 18 F-fluoromisonidazole) and MRI (T1, T2, dynamic enhanced, and diffusion-weighted sequences) were performed before, during, and after radiotherapy. Results: Median follow-up was 30.7 mo (range, 6.3-56.3 mo); in 7 patients, disease recurred. Disease-free survival correlated negatively with the maximum tissue-to-blood 18 F-fluoromisonidazole ratio (T/B max ) on the baseline 18 F-fluoromisonidazole scan (P 5 0.04), with the size of the initial hypoxic volume (P 5 0.04), and with T/B max on the 18 F-fluoromisonidazole scan during treatment (P 5 0.02). All locoregional recurrences were within the 18 F-FDGavid regions on baseline 18 F-FDG PET; 3 recurrences mapped outside the hypoxic volume on baseline 18 F-fluoromisonidazole PET. Lesions (primary tumor and lymph nodes) where a locoregional recurrence developed during follow-up had significantly lower apparent diffusion coefficients on diffusion-weighted MRI during week 4 of radiotherapy (0.0013 vs. 0.0018 mm 2 /s, P 5 0.01) and at 3 wk after treatment (0.0014 vs. 0.0018 mm 2 /s, P 5 0.01) and a significantly higher initial slope on baseline dynamic enhanced MRI (26.2 vs. 17.5/s, P 5 0.03) than did lesions that remained controlled. Conclusion: These results confirm the added value of 18 F-FDG PET and 18 F-fluoromisonidazole PET for radiotherapy planning of HNSCC and suggest the potential of diffusion-weighted and dynamic enhanced MRI for dose painting and early response assessment.

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Correlation between fluorodeoxyglucose hotspots on pretreatment positron emission tomography/CT and preferential sites of local relapse after chemoradiotherapy for head and neck squamous cell carcinoma

et al. 2017

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Our study does not find high overlap index values between the initial tumor and recurrence subvolumes, probably because of a suboptimal coregistration. Our results also confirm that metabolic tumor volume and total lesion glycolysis are independently correlated with recurrence-free survival in patients with HNSCC. Further larger prospective studies with FDG-PET/CT performed in the same RT position and with a validated elastic registration method are needed. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1155-1165, 2017.

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Positron Emission Tomography-Guided, Focal-Dose Escalation Using Intensity-Modulated Radiotherapy for Head and Neck Cancer

Cited by 195 publications

References 25 publications

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Correlation between fluorodeoxyglucose hotspots on pretreatment positron emission tomography/CT and preferential sites of local relapse after chemoradiotherapy for head and neck squamous cell carcinoma

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Positron Emission Tomography-Guided, Focal-Dose Escalation Using Intensity-Modulated Radiotherapy for Head and Neck Cancer

Cited by 195 publications

References 25 publications

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Correlation between pretreatment FDG-PET biological target volume and anatomical location of failure after radiation therapy for head and neck cancers

Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with18F-FDG PET,18F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI

Correlation between fluorodeoxyglucose hotspots on pretreatment positron emission tomography/CT and preferential sites of local relapse after chemoradiotherapy for head and neck squamous cell carcinoma

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Dose Painting in Radiotherapy for Head and Neck Squamous Cell Carcinoma: Value of Repeated Functional Imaging with¹⁸F-FDG PET,¹⁸F-Fluoromisonidazole PET, Diffusion-Weighted MRI, and Dynamic Contrast-Enhanced MRI