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

Miller, Jacob A.; Moradi, Farshad; Sundaram, Vandana; Liang, Ruyi; Zhang, Carrie; Nguyen, Ngan; Akhtar, Faisal; Liu, Yuhan; Ren, Yanling; Harandi, N.; Weng, Yingjie; Pollom, Erqi L.; Colevas, A. Dimitrios; Divi, Vasu; Holsinger, F. Christopher; Beadle, Beth M.; Le, Quynh‐Thu; Gensheimer, Michael F.

doi:10.1002/hed.27160

Cited by 8 publications

(3 citation statements)

References 34 publications

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“…Recently, posttreatment FDG-PET/CT Hopkins criteria showed an accuracy of 85% for predicting locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma. [ 14 ] In our study, HAN-MI-RADS sensitivity was near similar at 3 months, and 1 year with an accuracy of 88.6% up to 2 years. Hopkins score showed no significant time dependency in our study and a better accuracy of 92.9%.…”

Section: Discussionsupporting

confidence: 61%

Effectiveness of Head-and-Neck Molecular Imaging Reporting and Data System Criterion in Head-and-Neck Squamous Cell Carcinoma PostConcurrent Chemoradiotherapy

Gupta,

Jajodia,

Ahlawat

et al. 2023

Indian Journal of Nuclear Medicine

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Purpose: Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations were needed. We tested the effectiveness of a proposed semi-quantitative molecular response criterion in these patients. Materials and Methods: Two subspecialty-trained physicians evaluated 18F-fluorodeoxyglucose positron emission tomography/computed tomography of LA-HNSCC patients (n = 83) post 3 months CRT using a five points Head and Neck Molecular Imaging-Reporting and Data System (HAN-MI-RADS) criterion. Where available, histopathology examination with clinical and imaging interpretation was taken as a reference for the disease. A diagnostic accuracy comparison was done with the existing Hopkins score. Further effectiveness was analyzed with disease-free survival (DFI) and overall survival (OS). Results: Metastasis was developed in 11/83 patients at 3 months of evaluation. Of 72 patients, 39, 2, and 31 patients had a complete response, equivocal response, and partial response as per HAN-MI-RADS. Per patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting loco-regional disease up to 1 and 2 years was 93.3%, 92.5%, 90.3%, 94.9%, 92.9%, and 84.9%, 91.9%, 90.3%, 87.2%, and 88.6% respectively. One year and two years DFI for each HAN-MI-RADS score showed a statistically significant difference while it was not for OS. The receiver operating characteristic curve analysis showed significantly better outcome predictability of HAN-MI-RADS (area under the curve [AUC] 0.884) than Hopkins (AUC 0.699). Conclusions: A five points HAN-MI-RADS criterion was found promising for response assessment with less equivocal results and statistically significant higher AUC than Hopkins for loco-regional recurrence prediction.

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Section: Discussionsupporting

confidence: 61%

Effectiveness of Head-and-Neck Molecular Imaging Reporting and Data System Criterion in Head-and-Neck Squamous Cell Carcinoma PostConcurrent Chemoradiotherapy

Gupta,

Jajodia,

Ahlawat

et al. 2023

Indian Journal of Nuclear Medicine

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“…These criteria have an excellent interobserver agreement and a high negative predictive value (reported NPV of up to 95%). A recently published validation study on 259 patients with 18 F-FDG PET following definitive radiotherapy for oropharyngeal squamous cell carcinoma showed that a positive Hopkin’s score was associated with local residual disease/recurrence rate of 45% compared to 5% when negative (Hazard ratio, 12.60; p < 0.001) ( 25 ) and these are also predictive of PFS and OS ( 26 ). Additionally, post-therapy the Hopkins criteria on 18 F-FDG PET may identify clinically unsuspected residual disease in up to 19.5% of patients ( 24 , 27 ).…”

Section: Reporting Schemes and Classificationsmentioning

confidence: 99%

Standardized classification schemes in reporting oncologic PET/CT

et al. 2023

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The imaging report is essential for the communication between physicians in patient care. The information it contains must be clear, concise with evidence-based conclusions and sufficient to support clinical decision-making. In recent years, several classification schemes and/or reporting guidelines for PET have been introduced. In this manuscript, we will review the classifications most frequently used in oncology for interpreting and reporting 18F-FDG PET imaging in lymphoma, multiple myeloma, melanoma and head and neck cancers, PSMA-ligand PET imaging for prostate cancer, and 68Ga-DOTA-peptide PET in neuroendocrine tumors (NET).

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“…Each patient was followed up by repeated clinical examinations, and findings of recurrence of tumor were documented. No uniform definition of recurrence exists [ 17 , 18 , 19 ]. In the present study, we have used 6 months as a cutoff and defined recurrence as follows: Recurrence was divided into residual disease (defined as loco-regional recurrence <6 months post-treatment), loco-regional recurrence (defined as loco-regional recurrence ≥6 months post-treatment), or general failure/distant metastasis (defined as distant metastasis >6 months post-treatment).…”

Section: Methodsmentioning

confidence: 99%

Higher Risk of Recurrence in Patients Treated for Head and Neck Cancer with Low BMI and Elevated Levels of C-Reactive Protein

Spiegelberg

Malmberg

Ehrsson

et al. 2022

Cancers

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This prospective study identifies high-risk groups for recurrence of head and neck cancer by BMI and circulating inflammatory response markers. Head and neck cancer patients from three Swedish hospitals were included (n = 272). Leukocyte and thrombocyte counts, CRP levels, and BMI were measured pre-treatment and post-treatment. Associations between the four factors and treatment failure (residual tumor, loco-regional failure, general failure/distant metastasis) were assessed using a Cox proportional hazards model adjusted for sex, age at the initial visit, smoking status, cancer stage, and hemoglobin count. CRP level was the only significant single variable, with an average increase in risk of recurrence of 74% (p = 0.018) for every doubling. The predictive power of a combined model using all variables was highest during the initial months after treatment, with AUC under the ROC curve 0.75 at the 0–3 month timepoints. Patients with elevated pre- and post-treatment CRP levels are at higher risk for recurrence of disease. Male patients with low post-treatment BMI, advanced stage, and high CRP at any time post treatment are at high risk for recurrence. The combined model may be useful for stratifying post-treatment patients into low and high-risk groups, to enable more detailed follow-up or additional treatment regimens.

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

Cited by 8 publications

References 34 publications

Effectiveness of Head-and-Neck Molecular Imaging Reporting and Data System Criterion in Head-and-Neck Squamous Cell Carcinoma PostConcurrent Chemoradiotherapy

Effectiveness of Head-and-Neck Molecular Imaging Reporting and Data System Criterion in Head-and-Neck Squamous Cell Carcinoma PostConcurrent Chemoradiotherapy

Standardized classification schemes in reporting oncologic PET/CT

Higher Risk of Recurrence in Patients Treated for Head and Neck Cancer with Low BMI and Elevated Levels of C-Reactive Protein

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