Pre–Radiation Therapy Fluorine 18 Fluorodeoxyglucose PET Helps Identify Patients with Esophageal Cancer at High Risk for Radiation Pneumonitis

Castillo, Richard; Pham, N.; Castillo, Edward M.; Aso-González, S.; Ansari, Shoaib; Hobbs, Brian P.; Palacio, Diana; Skinner, Heath D.; Guerrero, Thomas

doi:10.1148/radiol.14140457

Cited by 32 publications

(42 citation statements)

References 43 publications

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“…Contrary to other studies, the present work demonstrated that CT texture change correlates with RP development. Other groups compared pre‐treatment CT Hounsfield unit (HU) statistics calculated over the entire lung volume to SUV and determined that CT values were not associated with RP.…”

Section: Discussioncontrasting

confidence: 99%

“…While other dosimetric parameters such as V5 could have been studied, it is unlikely that results would differ because dosimetric parameters tend to be highly correlated . Furthermore, analysis of the parent data set from which the data set in the present study was obtained indicated no correlation of V5, V10, V20, V30, or MLD with RP development, a finding that is not expected to change in this smaller subset …”

Section: Discussionmentioning

confidence: 69%

“…A subset of the PET images used by Castillo et al were acquired with calculated SUV values. For each patient, the raw PET images were converted to SUV maps on a pixel‐by‐pixel basis according to the following equation:

S t a n d a r d U p t a k e V a l u e false(S U V false) = \frac{^{18} F \frac{}{} F D G c o u n t r a t e p e r m L \times b o d y w e i g h t false(g m false)}{d e c a y c o r r e c t e d^{18} F \frac{}{} F D G i n j e c t e d d o s e false(B q false)}

…”

Section: Methodsmentioning

confidence: 99%

“…This resulted in a single value for each statistic to characterize the pre‐treatment tracer uptake in the lungs. The degree of overlap between high‐uptake (e.g., SUV 95 or higher) and high‐dose regions of the lung was not evaluated, as it had been previously determined that this relationship did not contribute to the risk of RP in the parent database …”

Section: Methodsmentioning

confidence: 99%

“…Naqa et al determined the post‐ to pre‐therapy ratios of α2M and interleukin‐6 (IL‐6) to be predictive of RP development in NSCLC patients. Castillo et al hypothesized that patients with naturally stronger immune responses would also be more susceptible to RP development and examined [ 18 F]‐2‐fluoro‐2‐deoxyglucose ( 18 F‐FDG) uptake levels in the lungs from pre‐therapy positron emission tomography (PET) scans of NSCLC patients and esophageal cancer patients . The functional data conveyed by the parameter SUV 95 , indicative of pre‐RT “background” lung inflammation, was found to be predictive of subsequent symptomatic RP …”

Section: Introductionmentioning

confidence: 99%

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Incorporation of pre-therapy ¹⁸ F-FDG uptake data with CT texture features into a radiomics model for radiation pneumonitis diagnosis

et al. 2017

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Purpose To determine whether the addition of standardized uptake value (SUV) from PET scans to CT lung texture features could improve a radiomics-based model of radiation pneumonitis (RP) diagnosis in patients undergoing radiotherapy. Methods and Materials Anonymized data from 96 esophageal cancer patients (18 RP-positive cases of Grade ≥ 2) were collected including pre-therapy PET/CT scans, pre-/post-therapy diagnostic CT scans and RP status. Twenty texture features (first-order, fractal, Laws’ filter and gray-level co-occurrence matrix) were calculated from diagnostic CT scans and compared in anatomically matched regions of the lung. Classifier performance (texture, SUV, or combination) was assessed by calculating the area under the receiver operating characteristic curve (AUC). For each texture feature, logistic regression classifiers consisting of the average change in texture feature value and the pre-therapy SUV standard deviation (SUVSD) were created and compared with the texture feature as a lone classifier using ANOVA with correction for multiple comparisons (p < 0.0025). Results While clinical parameters (mean lung dose, smoking history, tumor location) were not significantly different among patients with and without symptomatic RP, SUV and texture parameters were significantly associated with RP status. AUC for single-texture-feature classifiers alone ranged from 0.58–0.81 and 0.53–0.71 in high-dose (≥ 30 Gy) and low-dose (< 10 Gy) regions of the lungs, respectively. AUC for SUVSD alone was 0.69 (95% confidence interval: 0.54–0.83). Adding SUVSD into a logistic regression model significantly increased the mean AUC across 11–18 texture features by 0.08, 0.06, 0.04 in the low-, medium-, and high-dose regions, respectively. Conclusions Addition of SUVSD to a single texture feature improves classifier performance on average, but the improvement is smaller in magnitude when SUVSD is added to an already effective classifier using texture alone. These findings demonstrate the potential for more accurate assessment of RP using information from multiple imaging modalities.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 69%

S t a n d a r d U p t a k e V a l u e false(S U V false) = \frac{^{18} F \frac{}{} F D G c o u n t r a t e p e r m L \times b o d y w e i g h t false(g m false)}{d e c a y c o r r e c t e d^{18} F \frac{}{} F D G i n j e c t e d d o s e false(B q false)}

…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Incorporation of pre-therapy ¹⁸ F-FDG uptake data with CT texture features into a radiomics model for radiation pneumonitis diagnosis

et al. 2017

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Cardiac metabolic changes on ¹⁸F‐positron emission tomography after thoracic radiotherapy predict for overall survival in esophageal cancer patients

Zakem

Jones

Castillo

et al. 2022

J Applied Clin Med Phys

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PurposeHeart doses have been shown to be predictive of cardiac toxicity and overall survival (OS) for esophageal cancer patients. There is potential for functional imaging to provide valuable cardiac information. The purpose of this study was to evaluate the cardiac metabolic dose–response using 18F‐deoxyglucose (FDG)–PET and to assess whether standard uptake value (SUV) changes in the heart were predictive of OS.MethodsFifty‐one patients with esophageal cancer treated with radiation who underwent pre‐ and post‐treatment FDG–PET scans were retrospectively evaluated. Pre‐ and post‐treatment PET‐scans were rigidly registered to the planning CT for each patient. Pre‐treatment to post‐treatment absolute mean SUV (SUVmean) changes in the heart were calculated to assess dose–response. A dose–response curve was generated by binning each voxel in the heart into 10 Gy dose‐bins and analyzing the SUVmean changes in each dose‐bin. Multivariate cox proportional hazard models were used to assess whether pre‐to‐post treatment cardiac SUVmean changes predicted for OS.ResultsThe cardiac dose–response curve demonstrated a trend of increasing cardiac SUV changes as a function of dose with an average increase of 0.044 SUV for every 10 Gy dose bin. In multivariate analysis, disease stage and SUVmean change in the heart were predictive (p < 0.05) for OS.ConclusionsChanges in pre‐ to post‐treatment cardiac SUV were predictive of OS with patients having a higher pre‐ to post‐treatment cardiac SUV change surviving longer.

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The utility of quantitativeCTradiomics features for improved prediction of radiation pneumonitis

et al. 2018

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Pre–Radiation Therapy Fluorine 18 Fluorodeoxyglucose PET Helps Identify Patients with Esophageal Cancer at High Risk for Radiation Pneumonitis

Cited by 32 publications

References 43 publications

Incorporation of pre-therapy ¹⁸ F-FDG uptake data with CT texture features into a radiomics model for radiation pneumonitis diagnosis

Incorporation of pre-therapy ¹⁸ F-FDG uptake data with CT texture features into a radiomics model for radiation pneumonitis diagnosis

Cardiac metabolic changes on ¹⁸F‐positron emission tomography after thoracic radiotherapy predict for overall survival in esophageal cancer patients

The utility of quantitativeCTradiomics features for improved prediction of radiation pneumonitis

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Pre–Radiation Therapy Fluorine 18 Fluorodeoxyglucose PET Helps Identify Patients with Esophageal Cancer at High Risk for Radiation Pneumonitis

Cited by 32 publications

References 43 publications

Incorporation of pre-therapy 18 F-FDG uptake data with CT texture features into a radiomics model for radiation pneumonitis diagnosis

Incorporation of pre-therapy 18 F-FDG uptake data with CT texture features into a radiomics model for radiation pneumonitis diagnosis

Cardiac metabolic changes on 18F‐positron emission tomography after thoracic radiotherapy predict for overall survival in esophageal cancer patients

The utility of quantitativeCTradiomics features for improved prediction of radiation pneumonitis

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Product

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Incorporation of pre-therapy ¹⁸ F-FDG uptake data with CT texture features into a radiomics model for radiation pneumonitis diagnosis

Incorporation of pre-therapy ¹⁸ F-FDG uptake data with CT texture features into a radiomics model for radiation pneumonitis diagnosis

Cardiac metabolic changes on ¹⁸F‐positron emission tomography after thoracic radiotherapy predict for overall survival in esophageal cancer patients