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Local relapse of nasopharyngeal cancer and Voxel-based analysis of FMISO uptake using PET with semiconductor detectors

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Title: Local relapse of nasopharyngeal cancer and Voxel-based analysis of FMISO uptake using PET with semiconductor detectors
Authors: Nishikawa, Yukiko Browse this author
Yasuda, Koichi Browse this author →KAKEN DB
Okamoto, Shozo Browse this author
Ito, Yoichi M. Browse this author →KAKEN DB
Onimaru, Rikiya Browse this author →KAKEN DB
Shiga, Tohru Browse this author →KAKEN DB
Tsuchiya, Kazuhiko Browse this author →KAKEN DB
Watanabe, Shiro Browse this author
Takeuchi, Wataru Browse this author
Kuge, Yuji Browse this author →KAKEN DB
Peng, Hao Browse this author
Tamaki, Nagara Browse this author →KAKEN DB
Shirato, Hiroki Browse this author →KAKEN DB
Keywords: [18F]fluoromisonidazole
Positron emission tomography
Intensity-modulated radiotherapy
Nasopharyngeal carcinoma
Issue Date: 6-Sep-2017
Publisher: BioMed Central
Journal Title: Radiation oncology
Volume: 12
Start Page: 148
Publisher DOI: 10.1186/s13014-017-0886-9
Abstract: Background: Hypoxic cancer cells are thought to be radioresistant and could impact local recurrence after radiotherapy (RT). One of the major hypoxic imaging modalities is [18F]fluoromisonidazole positron emission tomography (FMISO-PET). High FMISO uptake before RT could indicate radioresistant sites and might be associated with future local recurrence. The predictive value of FMISO-PET for intra-tumoral recurrence regions was evaluated using high-resolution semiconductor detectors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy (IMRT). Methods: Nine patients with local recurrence and 12 patients without local recurrence for more than 3 years were included in this study. These patients received homogeneous and standard doses of radiation to the primary tumor irrespective of FMISO uptake. The FMISO-PET image before RT was examined via a voxel-based analysis, which focused on the relationship between the degree of FMISO uptake and recurrence region. Results: In the pretreatment FMISO-PET images, the tumor-to-muscle ratio (TMR) of FMISO in the voxels of the tumor recurrence region was significantly higher than that of the non-recurrence region (p < 0.0001). In the recurrent patient group, a TMR value of 1.37 (95% CI: 1.36-1.39) corresponded to a recurrence rate of 30%, the odds ratio was 5.18 (4.87-5.51), and the area under the curve (AUC) of the receiver operating characteristic curve was 0.613. In all 21 patients, a TMR value of 2.42 (2.36-2.49) corresponded to an estimated recurrence rate of 30%, and the AUC was only 0.591. Conclusions: The uptake of FMISO in the recurrent region was significantly higher than that in the non-recurrent region. However, the predictive value of FMISO-PET before IMRT is not sufficient for up-front dose escalation for the intra-tumoral high-uptake region of FMISO. Because of the higher mean TMR of the recurrence region, a new hypoxic imaging method is needed to improve the sensitivity and specificity for hypoxia.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
国際連携研究教育局 : GI-CoRE (Global Institution for Collaborative Research and Education : GI-CoRE) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 安田 耕一

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