Therapy Response Assessment and Patient Outcomes in Head and Neck Squamous Cell Carcinoma: FDG PET Hopkins Criteria Versus Residual Neck Node Size and Morphologic Features

Wray, Rick Arthur; Sheikhbahaei, Sara; Marcus, Charles; Zan, Elçin; Ferraro, Regan; Rahmim, Arman; Subramaniam, Rathan M.

doi:10.2214/ajr.15.15730

Cited by 30 publications

(19 citation statements)

References 16 publications

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“…[15][16][17][18][19][20][21][22] Three major response assessment criteria in neuroradiology that use this simplified approach are the Lugano criteria for lymphoma and the Hopkins and Neck Imaging Reporting and Data Systems (NI-RADS) criteria for solid tumors of the head and neck. 15,16,[23][24][25][26] The Lugano and Hopkins criteria use relatively stable internal reference standards for metabolism found on every examination, blood pool, and liver intensities, which minimizes the variation in response assessments related to differences in patients, examination protocols, scanner characteristics, and readers. 15,25 The NI-RADS criteria use a combination of contrast-enhanced CT, together with the PET-CT findings, to provide anatomic evaluation in areas of increased metabolic activity.…”

Section: Qualitative Tumor Response Evaluationmentioning

confidence: 99%

“…15,16,[23][24][25][26] The Lugano and Hopkins criteria use relatively stable internal reference standards for metabolism found on every examination, blood pool, and liver intensities, which minimizes the variation in response assessments related to differences in patients, examination protocols, scanner characteristics, and readers. 15,25 The NI-RADS criteria use a combination of contrast-enhanced CT, together with the PET-CT findings, to provide anatomic evaluation in areas of increased metabolic activity. 26 In this article, we describe the development of these 3 criteria and their use in daily practice, and provide illustrative examples of the utility of these tools in the modern evaluation of tumor response.…”

Section: Qualitative Tumor Response Evaluationmentioning

confidence: 99%

“…disease was time dependent, and follow-up surveillance imaging was recommended at 1 year after therapy; however, guidelines with regard to posttreatment surveillance imaging are not well established, with some experienced Radiologists suggesting shorter intervals of as little as 12 weeks. Wray et al 25 demonstrated that the Hopkins criteria and FDG-PET/CT assessment after head and neck squamous cell carcinoma chemoradiotherapy was significantly better than residual neck node size in predicting overall survival and progression-free survival. In an external validation study, Kendi et al 24 investigated the use of the Hopkins criteria in patients with head and neck squamous cell carcinoma after radiation therapy.…”

Section: Development Of the Hopkins Criteria For Head And Neck Tumorsmentioning

confidence: 99%

“…The timing and type of treatment seems to have a significant impact on the positive predictive value and sensitivity of the Hopkins criteria. Wray et al 25 indicate that posttreatment inflammatory changes or false-positives can mostly be avoided if the PET/CT is performed $12 weeks after the completion of radiation therapy. Taghipour et al 52 indicate that postsurgical patients may not have as much posttreatment inflammation as postradiation patients, so scans could potentially be performed earlier.…”

Section: Using the Hopkins Criteria For Evaluating Head And Neck Tumomentioning

confidence: 99%

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RESISTing the Need to Quantify: Putting Qualitative FDG-PET/CT Tumor Response Assessment Criteria into Daily Practice

Peacock

Christensen

Banks

2019

AJNR Am J Neuroradiol

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Tumor response assessments are essential to evaluate cancer treatment efficacy and prognosticate survival in patients with cancer. Response criteria have evolved over multiple decades, including many imaging modalities and measurement schema. Advances in FDG-PET/CT have led to tumor response criteria that harness the power of metabolic imaging. Qualitative PET/CT assessment schema are easy to apply clinically, are reproducible, and yield good prognostic results. We present 3 such criteria, namely, the Lugano classification for lymphoma, the Hopkins criteria, and the Neck Imaging Reporting and Data Systems criteria for head and neck cancers. When comparing baseline PET/CTs with interim or end-of-treatment PET/CTs, radiologists can classify the tumor response as complete metabolic response, partial metabolic response, no metabolic response, or progressive disease, which has important implications in directing further cancer management and long-term patient prognosis. The purpose of this article is to review the progression of tumor response assessments from CT-and PET/CT-based quantitative and semi-quantitative systems to PET/CT-based qualitative systems; introduce the classification schema for these systems; and describe how to use these rapid, powerful, and qualitative PET/CT-based systems in daily practice through illustrative cases. ABBREVIATIONS: CMR 4 complete metabolic response; D5PS 4 Deauville 5-point scale; NI-RADS 4 Neck Imaging Reporting and Data Systems; PD 4 relapsed/progressive disease; PERCIST 4 PET Response Criteria in Solid Tumors; RECIST 4 Response Evaluation Criteria in Solid Tumors; WHO 4 World Health Organization; HNSCCa 4 Head and Neck squamous cell carcinoma; ACR 4 American college of radiology; AUC 4 appropriate use criteria; SCCa 4 squamous cell carcinoma; PPD 4 product of the diameters; SPD 4 sum of the product of the diameters

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Section: Qualitative Tumor Response Evaluationmentioning

confidence: 99%

Section: Qualitative Tumor Response Evaluationmentioning

confidence: 99%

Section: Development Of the Hopkins Criteria For Head And Neck Tumorsmentioning

confidence: 99%

Section: Using the Hopkins Criteria For Evaluating Head And Neck Tumomentioning

confidence: 99%

See 2 more Smart Citations

RESISTing the Need to Quantify: Putting Qualitative FDG-PET/CT Tumor Response Assessment Criteria into Daily Practice

Peacock

Christensen

Banks

2019

AJNR Am J Neuroradiol

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“…Response following RT is assessed with imaging and clinical examination 10–12 weeks following RT completion [ 6 , 7 ]. Tumor size change is often a delayed manifestation resulting from the accumulation of cell death and microstructural changes within the treated tumor [ 8 ].…”

mentioning

confidence: 99%

Quantitative Ultrasound Delta-Radiomics During Radiotherapy for Monitoring Treatment Responses in Head and Neck Malignancies

et al. 2020

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Aim: We investigated quantitative ultrasound (QUS) in patients with node-positive head and neck malignancies for monitoring responses to radical radiotherapy (RT). Materials & methods: QUS spectral and texture parameters were acquired from metastatic lymph nodes 24 h, 1 and 4 weeks after starting RT. K-nearest neighbor and naive-Bayes machine-learning classifiers were used to build prediction models for each time point. Response was detected after 3 months of RT, and patients were classified into complete and partial responders. Results: Single-feature naive-Bayes classification performed best with a prediction accuracy of 80, 86 and 85% at 24 h, week 1 and 4, respectively. Conclusion: QUS-radiomics can predict RT response at 3 months as early as 24 h with reasonable accuracy, which further improves into 1 week of treatment.

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Hopkins criteria for residual disease assessment after definitive radiotherapy in nasopharyngeal carcinoma

et al. 2019

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Objectives Assessment of viable tumor residue after definitive radiotherapy is essential in patients with nasopharyngeal carcinoma (NPC). This study aimed to investigate the use of Hopkins criteria on positron emission tomography/computed tomography (PET/CT) for posttreatment response evaluation and whether plasma Epstein‐Barr virus (EBV) DNA could bring additional value. Materials and methods NPC patients who underwent FDG‐PET/CT scan within 26 weeks after definitive radiotherapy were retrospectively reviewed. Residual disease was evaluated by Hopkins 5‐point score. Accuracy of Hopkins criteria before and after incorporating EBV DNA was calculated. Prognostic value for locoregional failure‐free survival (LRFFS) and disease‐free survival (DFS) was analyzed. Results One hundred and sixteen patients were evaluated. Median follow‐up time was 28.3 months (range 3.3‐92.0 months). Residual disease was found in 19 (16.4%) patients. Overall, Hopkins criteria had high specificity (86.6%; 95% CI, 78.2%‐92.7%) and negative prognostic value (NPV) (94.4%; 95% CI, 88.7%‐97.3%), while sensitivity and positive prognostic value (PPV) was 73.7% (95% CI, 48.8%‐90.9%), 51.9% (95% CI, 37.8%‐65.6%), respectively. Posttreatment plasma EBV DNA was not predictive of residual tumor (P = .272). PPV and accuracy were 50.0% (95% CI, 32.1%‐67.9%) and 83.0% (95% CI, 73.8%‐90.0%) after incorporating detectable EBV DNA into the scoring system. Positive PET/CT results were significantly correlated with inferior 3‐year LRFFS (95.7% vs 79.5%, P = .043) and 3‐year DFS (84.6% vs 54.4%, P = .028). Conclusions The Hopkins criteria demonstrated high NPV and specificity in posttreatment assessment, with the potential to be a reliable prognostic indicator for locoregional failure. Combining EBV DNA with PET/CT did not improve diagnostic accuracies. PET/CT should not be performed less than 12 weeks after treatment.

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Therapy Response Assessment and Patient Outcomes in Head and Neck Squamous Cell Carcinoma: FDG PET Hopkins Criteria Versus Residual Neck Node Size and Morphologic Features

Abstract: PET-based structured qualitative therapy assessment (Hopkins criteria) can predict survival outcomes of patients with HNSCC with residual neck nodes after definitive chemoradiotherapy.

Cited by 30 publications

References 16 publications

RESISTing the Need to Quantify: Putting Qualitative FDG-PET/CT Tumor Response Assessment Criteria into Daily Practice

RESISTing the Need to Quantify: Putting Qualitative FDG-PET/CT Tumor Response Assessment Criteria into Daily Practice

Quantitative Ultrasound Delta-Radiomics During Radiotherapy for Monitoring Treatment Responses in Head and Neck Malignancies

Hopkins criteria for residual disease assessment after definitive radiotherapy in nasopharyngeal carcinoma

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