Alterations in anatomic and functional imaging parameters with repeated FDG PET-CT and MRI during radiotherapy for head and neck cancer: a pilot study

BMC Cancer

Manil Subesinghe⁴  Andrew F Scarsbrook⁴  Steven Sourbron³  Daniel J Wilson²  Garry McDermott²  Richard Speight⁶  Neil Roberts⁵  Brendan Carey⁴  Roan Forrester³  Sandeep Vijaya Gopal³  Jonathan R Sykes⁶  Robin JD Prestwich¹ 

[1] St. James’ Institute of Oncology, Level 4 Bexley Wing, Beckett Street, Leeds LS9 7TF, UK

[2] Department of Medical Physics, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK

[3] Division of Medical Physics, University of Leeds, Leeds, UK

[4] Department of Clinical Radiology, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK

[5] Department of Radiotherapy, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK

[6] Department of Radiotherapy Physics, St. James’ University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK

关键词: Magnetic resonance imaging;    Positron-emission tomography;    Fluorodeoxyglucose F18;    Computed tomography;    Radiotherapy;    Head and neck neoplasms;   

Others  :  1143973
DOI  :  10.1186/s12885-015-1154-8

 received in 2014-07-16, accepted in 2015-03-02,  发布年份 2015

【 摘 要 】

Background

The use of imaging to implement on-treatment adaptation of radiotherapy is a promising paradigm but current data on imaging changes during radiotherapy is limited. This is a hypothesis-generating pilot study to examine the changes on multi-modality anatomic and functional imaging during (chemo)radiotherapy treatment for head and neck squamous cell carcinoma (HNSCC).

Methods

Eight patients with locally advanced HNSCC underwent imaging including computed tomography (CT), Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)-CT and magnetic resonance imaging (MRI) (including diffusion weighted (DW) and dynamic contrast enhanced (DCE)) at baseline and during (chemo)radiotherapy treatment (after fractions 11 and 21). Regions of interest (ROI) were drawn around the primary tumour at baseline and during treatment. Imaging parameters included gross tumour volume (GTV) assessment, SUV_max, mean ADC value and DCE-MRI parameters including Plasma Flow (PF). On treatment changes and correlations between these parameters were analysed using a Wilcoxon rank sum test and Pearson’s linear correlation coefficient respectively. A p-value <0.05 was considered statistically significant.

Results

Statistically significant reductions in GTV-CT, GTV-MRI and GTV-DW were observed between all imaging timepoints during radiotherapy. Changes in GTV-PET during radiotherapy were heterogeneous and non-significant. Significant changes in SUV_max, mean ADC value, Plasma Flow and Plasma Volume were observed between the baseline and the fraction 11 timepoint, whilst only changes in SUV_max between baseline and the fraction 21 timepoint were statistically significant. Significant correlations were observed between multiple imaging parameters, both anatomical and functional; 20 correlations between baseline to the fraction 11 timepoint; 12 correlations between baseline and the fraction 21 timepoints; and 4 correlations between the fraction 11 and fraction 21 timepoints.

Conclusions

Multi-modality imaging during radiotherapy treatment demonstrates early changes (by fraction 11) in both anatomic and functional imaging parameters. All functional imaging modalities are potentially complementary and should be considered in combination to provide multi-parametric tumour assessment, to guide potential treatment adaptation strategies.

Trial Registration

ISRCTN Registry: ISRCTN34165059 webcite. Registered 2nd February 2015.

【 授权许可】

   
2015 Subesinghe et al.; licensee BioMed Central.

【 图 表 】

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