| 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 |
| Hypoxia |
| 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. |
| Rights: | http://creativecommons.org/licenses/by/4.0/ |
| Type: | article |
| URI: | http://hdl.handle.net/2115/67571 |
| 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)
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