18F-FLT and 18F-FDG PET/CT in Predicting Response to Chemoradiotherapy in Nasopharyngeal Carcinoma: Preliminary Results

Shi, Qi; Yang, Zhongyi; Zhang, Yingjian; Hu, Chengfang

doi:10.1038/srep40552

Cited by 23 publications

(21 citation statements)

References 39 publications

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“…In this study, we found that the SUVmax and SUV min of 18 F-FLT PET/CT are significantly lower than the SUV max and SUV min of 18 F-FDG PET/CT, which is consistent with the results of previous studies (Table 1) [43]. These finding are in line with the results by study conducted by Shi et al (2017) who used the 78% approach for GTV delineation potential to predict tumor regression in NPC patients [21]. The preliminary results of that group reported that parameters of both FDG and FLT PET had medium to strong correlation with NPC tumor response after chemo-radiotherapy; thus this finding avoids the problem of incongruent imaging of tumor motion [21] .…”

Section: Discussionsupporting

confidence: 92%

“…Recent articles indicate that high doses modalities imaging and irradiation techniques are required to achieve optimal levels of tumor control in individual patients [20]. Among many clinical diagnosis and assisting tumor staging methods, 18 F-FDG PET/CT and 18 F-FLT PET/CT are the most acceptable and non-invasive procedures for the NPC staging and diagnosis [21]. Despite many technological advances, the target GTVs delineation of 18 F-FDG PET/CT and 18 F-FLT PET/CT in NPC are still controversial.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of different images in gross target volume delineating on VX2 nasopharyngeal transplantation tumor models

Xiang¹,

Imani²,

Hu³

et al. 2020

J. Cancer

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Background:To determine the optimum conditions for diagnosis of nasopharyngeal carcinoma, we established VX2 rabbit model to delineate gross target volume (GTV) in different imaging methods. Methods: The orthotopic nasopharyngeal carcinoma (NPC) was established in sixteen New Zealand rabbits. After 7-days inoculation, the rabbits were examined by CT scanning and then sacrificed for pathological examination. To achieve the best delineation, different GTVs of CT, MRI, 18 F-FDG PET/CT, and 18 F-FLT PET/CT images were correlated with pathological GTV (GTVp). Results:We found 45% and 60% of the maximum standardized uptake value (SUV max ) as the optimal SUV threshold for the target volume of NPC in 18 F-FDG PET/CT and 18 F-FLT PET/CT images, respectively (GTV FDG45% and GTV FLT60% ). Moreover, the GTV MRI and GTV CT were significantly higher than the GTVp (P ≤ 0.05), while the GTV FDG45% and especially GTV FLT60% were similar to the GTVp (R = 0.892 and R = 0.902, respectively; P ≤ 0.001). Conclusions: Notably, the results suggested that 18 F-FLT PET/CT could reflect the tumor boundaries more accurately than 18 F-FDG PET/CT, MRI and CT, which makes 18 F-FLT PET-CT more advantageous for the clinical delineation of the target volume in NPC.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Comparison of different images in gross target volume delineating on VX2 nasopharyngeal transplantation tumor models

Xiang¹,

Imani²,

Hu³

et al. 2020

J. Cancer

View full text Add to dashboard Cite

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“…FLT-PET has been used to predict the outcomes of various malignancies, including head and neck cancers treated by radiotherapy 23 , 27 - 34 . The prognostic value of FLT-PET in head and neck squamous cell carcinoma (HNSCC) was demonstrated in previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Among those studies on HNSCC, only 3 NPC patients were included. Recently, a study of 22 patients with primary NPC was conducted to assess the role of FLT-PET in monitoring treatment response 34 . The authors suggested that FLT-PET/CT performed before and after induction chemotherapy prior to chemoradiotherapy might play a role in monitoring the tumor regression; however, its prognostic value was not examined because of the limited sample size and absence of recurrence or death due to the well prognosis of primary NPC.…”

Section: Discussionmentioning

confidence: 99%

Volumetric parameters derived from FLT-PET performed at completion of treatment predict efficacy of Carbon-ion Radiotherapy in patients with locally recurrent Nasopharyngeal Carcinoma

Hu¹,

Yang²,

Gao³

et al. 2020

J. Cancer

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The purpose of this study was to investigate the role of 3'-deoxy-3'-[ 18 F]fluorothymidine (FLT)-PET for predicting the outcome of patients with locally recurrent nasopharyngeal carcinoma (LR-NPC) treated by carbon-ion radiotherapy (CIRT). Patients received FLT-PET/CT scan one-week prior to or after completion of CIRT were enrolled in the study. All patients were from prospective trials or treated using a standardized protocol. Time-dependent receiver operator characteristics (ROC) were used to determine the optimal cutoff values for FLT-PET parameters. Univariable and multivariable analyses of local progression-free survival (LPFS) were performed using Cox regression, to examine the prognostic value of FLT-PET parameters, including SUV max , metabolic tumor volume (MTV) and total lesion thymidine (TLT). A total of 41 patients were enrolled. Elevated MTV and TLT were significantly associated with worse LPFS, in both univariable and multivariable analyses. ROC analysis revealed that both an MTV value higher than 8.6 and a TLT value higher than 14.9 were predictive of increased risk of developing local recurrence, the adjusted HRs were 5.59 ( p =0.009) and 7.76 ( p =0.002), respectively. In conclusion, FLT-PET was found to be a promising prognostic tool for LR-NPC patients and might play a role in the treatment guidance.

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“…Nevertheless, because of the influence of the partial volume effect (PVE), tumor boundaries on PET images are blurred and the exact size of a tumor cannot be defined precisely. How to determine tumor boundaries and delineate the biologic target of a tumor has been an important focus of research (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21). Bearing this in mind, we undertook a computer-simulation study on various imaging parameters that might be encountered when conducting imaging with different device performances under various clinical situations.…”

Section: Introductionmentioning

confidence: 99%

A Formula to Calculate the Threshold for Radiotherapy Targets on PET Images: Simulation Study

et al. 2020

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Background: Positron emission tomography (PET) images are being applied for defining radiotherapy targets. However, a recognized method for defining radiotherapy targets is lacking. We investigate the threshold to outline the radiotherapy target of a tumor on PET images and its influencing factors, and then expressed it by formula. Methods: PET imaging for spherical tumors with a different tumor diameter (D), under different system resolutions [full width at half maximum (FWHM)], in different backgrounds with different pixel sizes, was simulated. PET images were analyzed to determine the relationship between the threshold and the factors mentioned above. Finally, the simulation results were verified by phantom experiments. Results: The threshold decreased sharply with D for D < 2 FWHM, reached the minimum of 31% at D = 2 FWHM and then increased slowly, and it tended to constant for D > 8 FWHM. The threshold decreased with FWHM for FWHM < D/2, reached a minimum at FWHM = D/2, and then increased. The threshold increased with pixel size for D ≤ FWHM and decreased for D > FWHM. The threshold was independent of the background. The relationship between the threshold and its influencing factors was expressed as a formula. The results of the phantom verification indicated that the error of the target volume delineation that was calculated by the formula was less than 9%. Conclusions: The threshold changes with tumor size, resolution of the PET system and pixel size according to certain rules. The formula to calculate the threshold could provide a method to estimate threshold to outline the radiotherapy target (tumor).

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18F-FLT and 18F-FDG PET/CT in Predicting Response to Chemoradiotherapy in Nasopharyngeal Carcinoma: Preliminary Results

Cited by 23 publications

References 39 publications

Comparison of different images in gross target volume delineating on VX2 nasopharyngeal transplantation tumor models

Comparison of different images in gross target volume delineating on VX2 nasopharyngeal transplantation tumor models

Volumetric parameters derived from FLT-PET performed at completion of treatment predict efficacy of Carbon-ion Radiotherapy in patients with locally recurrent Nasopharyngeal Carcinoma

A Formula to Calculate the Threshold for Radiotherapy Targets on PET Images: Simulation Study

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