Volumetric and texture analysis of pretherapeutic 18F-FDG PET can predict overall survival in medullary thyroid cancer patients treated with Vandetanib

Werner, Rudolf A.; Bundschuh, Ralph A.; Higuchi, Takahiro; Javadi, Mehrbod S.; Rowe, Steven P.; Zsótér, Norbert; Kroiß, Matthias; Fassnacht, Martin; Buck, Andreas K.; Kreißl, Michael C.; Lapa, Constantin

doi:10.1007/s12020-018-1749-3

Cited by 14 publications

(17 citation statements)

References 36 publications

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“…The hazard ratio for cancer-related death was 6.1 for complexity (TLG, 9.5). The obtained results led to conclude that TF complexity and the volumetric parameter TLG are both independent parameters for OS prediction 42…”

Section: Clinical Trials With Vandetanib In Mtcmentioning

confidence: 87%

“…The prognostic value of intratumoral textural features (TF) and volumetric parameters (total lesion glycolysis, TLG) derived by pre-therapeutic 18 F-FDG PET was investigated in 18 patients with progressive MTC 42. The TF complexity and TLG evaluated before vandetanib initiation successfully differentiated between low- and high-risk patients.…”

Section: Clinical Trials With Vandetanib In Mtcmentioning

confidence: 99%

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<p>Evaluating vandetanib in the treatment of medullary thyroid cancer: patient-reported outcomes</p>

Fallahi¹,

Ferrari²,

Elia³

et al. 2019

CMAR

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Medullary thyroid cancers (MTCs) are neuroendocrine tumors, which secrete calcitonin and carcinoembryonic antigen, both of which can serve as tumor markers. Extensive and accurate surgical resection is the primary treatment for MTC, whereas the use of external beam radiotherapy is limited. Moreover, since MTC is derived from thyroid parafollicular cells or C cells, it is not responsive to either radioiodine or thyroid-stimulating hormone suppression, and therefore, they cannot be considered as treatment strategies. Traditional therapies for advanced or metastatic progressive medullary thyroid cancer (pMTC) are poorly effective. Among the new approaches tested in clinical trials, targeted chemotherapies with tyrosine kinase inhibitors (TKIs) are now available and they represent effective interventions for progressive disease, with additional investigational options emerging. This paper reviews the efficacy and safety of vandetanib in patients with a pMTC, as it has been shown to improve progression-free survival (30.5 vs 19.3 months in controls). Vandetanib is approved by the FDA and EMA for symptomatic or progressive MTC in patients with unresectable locally advanced or metastatic disease in adults, adolescents, and children older than 5 years. The most common adverse events in vandetanib-treated patients are diarrhea, rash, folliculitis, nausea, QTc prolongation, hypertension, and fatigue. More data are required to deepen our knowledge on molecular biology of tumor and host defense, with the aim to achieve better prognosis and higher quality of life for affected patients.

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Section: Clinical Trials With Vandetanib In Mtcmentioning

confidence: 87%

Section: Clinical Trials With Vandetanib In Mtcmentioning

confidence: 99%

<p>Evaluating vandetanib in the treatment of medullary thyroid cancer: patient-reported outcomes</p>

Fallahi¹,

Ferrari²,

Elia³

et al. 2019

CMAR

View full text Add to dashboard Cite

show abstract

“…Subgroup analysis reveals that tumor grade and radiotracers may not affect the prognosis. 18 F-FDG is the most common PET imaging agent, which can non-invasively assess tumor glucose metabolism and proliferation (34,35). 18 F-FDG PET can be used not only for diagnosis and staging, but also for assessing the proliferative activity and malignancy of tumors.…”

Section: Discussionmentioning

confidence: 99%

“…However, SUV max reflects the value of a single voxel but does not represent the entire tumor. The volume parameters derived from PET in predicting the prognoses and monitoring the treatment can directly estimate systemic tumor burden, such as metabolic tumor volume (MTV) and total disease glycolysis (TLG), based on 2-deoxy-2-( 18 F) fluoro-D-glucose ( 18 F-FDG) (16)(17)(18)(19). However, well-differentiated NETs (WD-NETs) do not usually show high 18 F-FDG uptake (20).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Volume-Based Parameters Measured by SSTR PET/CT in Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

et al. 2021

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Purpose: A meta-analysis was conducted to investigate the value of the volume parameters based on somatostatin receptor (SSTR)-positron emission tomography (PET) in predicting the prognosis in patients with neuroendocrine tumors (NETs).Material: PUBMED, EMBASE, Cochrane library, and Web of Knowledge were searched from January 1990 to May 2021 for studies evaluating prognostic value of volume-based parameters of SSTR PET/CT in NETs. The terms used were “volume,” “positron emission tomography,” “neuroendocrine tumors,” and “somatostatin receptor.” Pooled hazard ratio (HR) values were calculated to assess the correlations between volumetric parameters, including total tumor volume (TTV) and total-lesion SSTR expression (TL-SSTR), with progression-free survival (PFS) and overall survival (OS). Heterogeneity and subgroup analysis were performed. Funnel plots, Begg's and Egger's test were used to assess possible underlying publication bias.Results: Eight eligible studies involving 593 patients were included in the meta-analysis. In TTV, the pooled HRs of its prognostic value of PFS and OS were 2.24 (95% CI: 1.73–2.89; P < 0.00001) and 3.54 (95% CI, 1.77–7.09; P = 0.0004), respectively. In TL-SSTR, the pooled HR of the predictive value was 1.61 (95% CI, 0.48–5.44, P = 0.44) for PFS.Conclusion: High TTV was associated with a worse prognosis for PFS and OS in with patients NETs. The TTV of SSTR PET is a potential objective prognosis predictor.

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“…Recent meta-analyses showed that various FDG PET features including SUVmax, MTV, and TLG were prognostic factors in multiple types of malignancies [39–42]. Also, heterogeneity features of FDG PET have shown to be associated with treatment response and clinical outcome in multiple types of malignancies [13, 15, 43–45]. Among the heterogeneity features, entropy and COV have been widely accepted and proven to be useful for predicting treatment response and clinical outcomes [13, 15, 44].…”

Section: Discussionmentioning

confidence: 99%

Association of metabolic and genetic heterogeneity in head and neck squamous cell carcinoma with prognostic implications: integration of FDG PET and genomic analysis

Choi

Gim

et al. 2019

EJNMMI Res

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PurposeThe linkage between the genetic and phenotypic heterogeneity of the tumor has not been thoroughly evaluated. Herein, we investigated how the genetic and metabolic heterogeneity features of the tumor are associated with each other in head and neck squamous cell carcinoma (HNSC). We further assessed the prognostic significance of those features.MethodsThe mutant-allele tumor heterogeneity (MATH) score (n = 508), a genetic heterogeneity feature, and tumor glycolysis feature (GlycoS) (n = 503) were obtained from the HNSC dataset in the cancer genome atlas (TCGA). We identified matching patients (n = 33) who underwent 18F-fluorodeoxyglucose positron emission tomography (FDG PET) from the cancer imaging archive (TCIA) and obtained the following information from the primary tumor: metabolic, metabolic-volumetric, and metabolic heterogeneity features. The association between the genetic and metabolic features and their prognostic values were assessed.ResultsTumor metabolic heterogeneity and metabolic-volumetric features showed a mild degree of association with MATH (n = 25, ρ = 0.4~0.5, P < 0.05 for all features). The patients with higher FDG PET features and MATH died sooner. Combination of MATH and tumor metabolic heterogeneity features showed a better stratification of prognosis than MATH. Also, higher MATH and GlycoS were associated with significantly worse overall survival (n = 499, P = 0.002 and 0.0001 for MATH and GlycoS, respectively). Furthermore, both MATH and GlycoS independently predicted overall survival after adjusting for clinicopathologic features and the other (P = 0.015 and 0.006, respectively).ConclusionBoth tumor metabolic heterogeneity and metabolic-volumetric features assessed by FDG PET showed a mild degree of association with genetic heterogeneity in HNSC. Both metabolic and genetic heterogeneity features were predictive of survival and there was an additive prognostic value when the metabolic and genetic heterogeneity features were combined. Also, MATH and GlycoS were independent prognostic factors in HNSC; they can be used for precise prognostication once validated.

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Volumetric and texture analysis of pretherapeutic 18F-FDG PET can predict overall survival in medullary thyroid cancer patients treated with Vandetanib

Cited by 14 publications

References 36 publications

<p>Evaluating vandetanib in the treatment of medullary thyroid cancer: patient-reported outcomes</p>

<p>Evaluating vandetanib in the treatment of medullary thyroid cancer: patient-reported outcomes</p>

Prognostic Value of Volume-Based Parameters Measured by SSTR PET/CT in Neuroendocrine Tumors: A Systematic Review and Meta-Analysis

Association of metabolic and genetic heterogeneity in head and neck squamous cell carcinoma with prognostic implications: integration of FDG PET and genomic analysis

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