The prognostic significance of intratumoral heterogeneity of 18F-FDG uptake in patients with oral cavity squamous cell carcinoma

Kimura, Masashi; Kato, Isao; Ishibashi, Kenichiro; Shibata, Akio; Nishiwaki, Shusuke; Fukumura, Masahiro; Sone, Yoshitsugu; Nagao, Toru; Umemura, Masayuki

doi:10.1016/j.ejrad.2019.03.004

“…In recent years, a quantitative intratumoral glucose metabolic heterogeneity indicator, namely heterogeneity factor (HF), which can be obtained by calculating metabolic volume-threshold function, has attracted significant attention [ 10 ]. Although numerous studies show that HF is closely related to the therapeutic response and prognosis of malignant tumors [ 11 – 13 ], discrimination between malignant and benign soft tissue and bone tumors utilizing this parameter remains unexplored.…”

Section: Introductionmentioning

confidence: 99%

Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F-FDG PET/CT-derived parameters

Chen

¹

,

Feng

²

,

Xie

³

et al. 2020

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Background Accurate differentiation between malignant and benign changes in soft tissue and bone lesions is essential for the prevention of unnecessary biopsies and surgical resection. Nevertheless, it remains a challenge and a standard diagnosis modality is urgently needed. The objective of this study was to evaluate the usefulness of 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT-derived parameters to differentiate soft tissue sarcoma (STS) and bone sarcoma (BS) from benign lesions. Methods Patients who had undergone pre-treatment 18 F-FDG PET/CT imaging and subsequent pathological diagnoses to confirm malignant (STS and BS, n = 37) and benign ( n = 33) soft tissue and bone lesions were retrospectively reviewed. The tumor size, PET and low-dose CT visual characteristics, maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneous factor (HF) of each lesion were measured. Univariate and multivariate logistic regression analyses were conducted to determine the significant risk factors to distinguish sarcoma from benign lesions. To establish a regression model based on independent risk factors, and the receiver operating characteristic curves (ROCs) of individual parameters and their combination were plotted and compared. Conventional imaging scans were re-analyzed, and the diagnostic performance compared with the regression model. Results Univariate analysis results revealed that tumor size, SUVmax, MTV, TLG, and HF of 18 F-FDG PET/CT imaging in the STS and BS group were all higher than in the benign lesions group (all P values were < 0.01). The differences in the visual characteristics between the two groups were also all statistically significant ( P < 0.05). However, the multivariate regression model only included SUVmax and HF as independent risk factors, for which the odds ratios were 1.135 (95%CI: 1.026 ~ 1.256, P = 0.014) and 7.869 (95%CI: 2.119 ~ 29.230, P = 0.002), respectively. The regression model was constructed using the following expression: Logit ( P ) = − 2.461 + 0.127SUVmax + 2.063HF. The area under the ROC was 0.860, which was higher than SUVmax (0.744) and HF (0.790). The diagnostic performance of the regression model was superior to those of individual parameters and conventional imaging. Conclusion The regression model including SUVmax and HF based on 18 F-FDG PET/CT imaging may be useful for differentiating STS and BS from benign lesions.

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“…Moreover Kimura et al evaluated HI in patients with oral cavity SCC and showed that it is a statistically significant prognostic factor for OS in patients with OSCC treated with primary surgery (63). Finally, although 18F-FDG is by far the most frequently used radiopharmaceutical in HNC, glycolysis is not the only metabolic process or biochemical pathway that can be visualized.…”

Section: Role Of Molecular Imaging In Researchmentioning

confidence: 99%

Prediction of Response in Head and Neck Tumor: Focus on Main Hot Topics in Research

Belgioia

¹

,

Morbelli

²

,

Corvò

³

2021

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Radiation therapy is a cornerstone in the treatment of head and neck cancer patients; actually, their management is based on clinical and radiological staging with all patients at the same stage treated in the same way. Recently the increasing knowledge in molecular characterization of head and neck cancer opens the way for a more tailored treatment. Patient outcomes could be improved by a personalized radiotherapy beyond technological and anatomical precision. Several tumor markers are under evaluation to understand their possible prognostic or predictive value. In this paper we discuss those markers specific for evaluate response to radiation therapy in head and neck cancer for a shift toward a biological personalization of radiotherapy.

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“…e concept of intratumor metabolic heterogeneity poses a challenge to patients' molecular stratification and treatment guidelines using a single tumor tissue sample [10]. In recent years, the ideas of 18 F-FDG PET/CT intratumor metabolic heterogeneity parameters, such as coefficient of variance, which is calculated through SUVmean divided by the standard deviation, and the slope of linear regression, which is calculated through linear regressions of MTVs according to different SUV thresholds, have been proven to reflect the characteristics of intratumor heterogeneity to some extent and to help predict prognosis in some solid tumors [11][12][13][14][15]. However, the intratumor metabolic heterogeneity prognostic value in colorectal cancer has not been studied.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Intratumor Metabolic Heterogeneity Parameters on 18F-FDG PET/CT for Patients with Colorectal Cancer

Liu

¹

,

Xiang

²

,

Geng

³

et al. 2022

Contrast Media & Molecular Imaging

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Purpose. Intratumor metabolic heterogeneity parameters on 18F-2-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) have been proven to be predictors of the clinical prognosis of cancer patients. The study aimed to examine the correlation between 18F-FDG PET-CT-defined heterogeneity parameters and the prognostic significance in patients with colorectal cancer. Methods. The study included 188 patients with colorectal cancer who received surgery and 18F-FDG PET/CT examinations. Preoperative 18F-FDG PET/CT conventional and metabolic heterogeneity parameters were collected, including maximum, peak, and mean standardized uptake value (SUVmax, SUVpeak, and SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), heterogeneity index-1 (HI-1) and heterogeneity index-2 (HI-2), and clinicopathological information. Correlations between these parameters and patient survival outcomes were inferred. Results. The associations between 18F-FDG PET/CT parameters and clinical outcomes were analyzed. Tumor thrombus ( P < 0.001 ), tumor stage ( P = 0.001 ), MTV ( P = 0.003 ), HI-1 ( P = 0.032 ), and HI-2 ( P = 0.001 ) differed between the two groups with and without recurrence. Multivariate analysis showed that, in the radical surgery group, HI-2 (HR = 1.10, 95% CI: 1.04–1.17, P = 0.001 ), tumor stage (HR = 20.65, 95% CI: 4.81–88.62, P < 0.001 ), and regional lymph nodes status (HR = 0.16, 95% CI: 0.04–0.57, P = 0.005 ) were independent variables significantly correlated with progression-free survival (PFS) and HI-2 (HR = 1.16, 95% CI: 1.07–1.26, P < 0.001 ) was an independent variable affecting overall survival (OS). In the palliative surgery group, HI-2 (HR = 1.03, 95% CI: 1.01–1.06, P = 0.020 ) was an independent variable affecting PFS, and all the parameters were not statistically significant for OS. Conclusion. HI-2, tumor stage, and regional lymph nodes status might predict the outcomes of colorectal cancer more effectively than other 18F-FDG PET/CT defined parameters.

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The prognostic significance of intratumoral heterogeneity of 18F-FDG uptake in patients with oral cavity squamous cell carcinoma

Cited by 19 publications

References 31 publications

Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F-FDG PET/CT-derived parameters

Differentiation of soft tissue and bone sarcomas from benign lesions utilizing 18F-FDG PET/CT-derived parameters

Prediction of Response in Head and Neck Tumor: Focus on Main Hot Topics in Research

Prognostic Value of Intratumor Metabolic Heterogeneity Parameters on 18F-FDG PET/CT for Patients with Colorectal Cancer

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