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Repeatability of hypoxia PET imaging using [¹⁸F]HX4 in lung and head and neck cancer patients: a prospective multicenter trial.

Zegers CM, van Elmpt W, Szardenings K, Kolb H, Waxman A, Subramaniam RM, Moon DH, Brunetti JC, Srinivas SM, Lambin P, Chien D - Eur. J. Nucl. Med. Mol. Imaging (2015)

Bottom Line: All parameters of [(18)F]HX4 uptake were significantly correlated between scans: SUVmax (r = 0.958, p < 0.001), SUVmean (r = 0.946, p < 0.001), TBRmax (r = 0.962, p < 0.001) and HV1.2 (r = 0.995, p < 0.001).The relative coefficients of repeatability were 15 % (SUVmean), 17 % (SUVmax) and 17 % (TBRmax).Voxel-wise analysis of the spatial uptake pattern within the tumors provided an average correlation of 0.65 ± 0.14.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands. Karen.zegers@maastro.nl.

ABSTRACT

Purpose: Hypoxia is an important factor influencing tumor progression and treatment efficacy. The aim of this study was to investigate the repeatability of hypoxia PET imaging with [(18)F]HX4 in patients with head and neck and lung cancer.

Methods: Nine patients with lung cancer and ten with head and neck cancer were included in the analysis (NCT01075399). Two sequential pretreatment [(18)F]HX4 PET/CT scans were acquired within 1 week. The maximal and mean standardized uptake values (SUVmax and SUVmean) were defined and the tumor-to-background ratios (TBR) were calculated. In addition, hypoxic volumes were determined as the volume of the tumor with a TBR >1.2 (HV1.2). Bland Altman analysis of the uptake parameters was performed and coefficients of repeatability were calculated. To evaluate the spatial repeatability of the uptake, the PET/CT images were registered and a voxel-wise comparison of the uptake was performed, providing a correlation coefficient.

Results: All parameters of [(18)F]HX4 uptake were significantly correlated between scans: SUVmax (r = 0.958, p < 0.001), SUVmean (r = 0.946, p < 0.001), TBRmax (r = 0.962, p < 0.001) and HV1.2 (r = 0.995, p < 0.001). The relative coefficients of repeatability were 15 % (SUVmean), 17 % (SUVmax) and 17 % (TBRmax). Voxel-wise analysis of the spatial uptake pattern within the tumors provided an average correlation of 0.65 ± 0.14.

Conclusion: Repeated hypoxia PET scans with [(18)F]HX4 provide reproducible and spatially stable results in patients with head and neck cancer and patients with lung cancer. [(18)F]HX4 PET imaging can be used to assess the hypoxic status of tumors and has the potential to aid hypoxia-targeted treatments.

No MeSH data available.


Related in: MedlinePlus

Examples of voxel-wise analysis in patients with lung cancer (patients 1 and 4). The axial plane of the CT scans with the gross tumor volumes delineated in yellow, the first [18F]HX4 PET scan, the rigidly registered second [18F]HX4 PET scan and the difference map from the two scans are shown
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Fig3: Examples of voxel-wise analysis in patients with lung cancer (patients 1 and 4). The axial plane of the CT scans with the gross tumor volumes delineated in yellow, the first [18F]HX4 PET scan, the rigidly registered second [18F]HX4 PET scan and the difference map from the two scans are shown

Mentions: An example of voxel-wise image analysis in a patient with head and neck cancer (patient 12) is shown in Fig. 2. Comparison of the heterogeneous uptake within the GTV between the first and second [18F]HX4 PET scans showed a moderate to strong correlation in the majority of patients, with an average correlation coefficient of 0.65 ± 0.14. There were two exceptions (patients 14 and 16) in whom a poor correlation was observed (R = 0.38 and 0.39). The average slope and intercept of the linear fit of the data were 0.56 ± 0.17 and 0.47 ± 0.19, respectively. The Bland-Altman analysis showed an average ΔSUV of 0.02 ± 0.06, with a lower and upper limit of agreement of 0.15 ± 0.09 and 0.19 ± 0.08. Examples of voxel-wise image analysis in patients with lung cancer (patients 1 and 4) are shown in Fig. 3. In addition, the results for each patient are shown in Table 3.Fig. 2


Repeatability of hypoxia PET imaging using [¹⁸F]HX4 in lung and head and neck cancer patients: a prospective multicenter trial.

Zegers CM, van Elmpt W, Szardenings K, Kolb H, Waxman A, Subramaniam RM, Moon DH, Brunetti JC, Srinivas SM, Lambin P, Chien D - Eur. J. Nucl. Med. Mol. Imaging (2015)

Examples of voxel-wise analysis in patients with lung cancer (patients 1 and 4). The axial plane of the CT scans with the gross tumor volumes delineated in yellow, the first [18F]HX4 PET scan, the rigidly registered second [18F]HX4 PET scan and the difference map from the two scans are shown
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4589564&req=5

Fig3: Examples of voxel-wise analysis in patients with lung cancer (patients 1 and 4). The axial plane of the CT scans with the gross tumor volumes delineated in yellow, the first [18F]HX4 PET scan, the rigidly registered second [18F]HX4 PET scan and the difference map from the two scans are shown
Mentions: An example of voxel-wise image analysis in a patient with head and neck cancer (patient 12) is shown in Fig. 2. Comparison of the heterogeneous uptake within the GTV between the first and second [18F]HX4 PET scans showed a moderate to strong correlation in the majority of patients, with an average correlation coefficient of 0.65 ± 0.14. There were two exceptions (patients 14 and 16) in whom a poor correlation was observed (R = 0.38 and 0.39). The average slope and intercept of the linear fit of the data were 0.56 ± 0.17 and 0.47 ± 0.19, respectively. The Bland-Altman analysis showed an average ΔSUV of 0.02 ± 0.06, with a lower and upper limit of agreement of 0.15 ± 0.09 and 0.19 ± 0.08. Examples of voxel-wise image analysis in patients with lung cancer (patients 1 and 4) are shown in Fig. 3. In addition, the results for each patient are shown in Table 3.Fig. 2

Bottom Line: All parameters of [(18)F]HX4 uptake were significantly correlated between scans: SUVmax (r = 0.958, p < 0.001), SUVmean (r = 0.946, p < 0.001), TBRmax (r = 0.962, p < 0.001) and HV1.2 (r = 0.995, p < 0.001).The relative coefficients of repeatability were 15 % (SUVmean), 17 % (SUVmax) and 17 % (TBRmax).Voxel-wise analysis of the spatial uptake pattern within the tumors provided an average correlation of 0.65 ± 0.14.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands. Karen.zegers@maastro.nl.

ABSTRACT

Purpose: Hypoxia is an important factor influencing tumor progression and treatment efficacy. The aim of this study was to investigate the repeatability of hypoxia PET imaging with [(18)F]HX4 in patients with head and neck and lung cancer.

Methods: Nine patients with lung cancer and ten with head and neck cancer were included in the analysis (NCT01075399). Two sequential pretreatment [(18)F]HX4 PET/CT scans were acquired within 1 week. The maximal and mean standardized uptake values (SUVmax and SUVmean) were defined and the tumor-to-background ratios (TBR) were calculated. In addition, hypoxic volumes were determined as the volume of the tumor with a TBR >1.2 (HV1.2). Bland Altman analysis of the uptake parameters was performed and coefficients of repeatability were calculated. To evaluate the spatial repeatability of the uptake, the PET/CT images were registered and a voxel-wise comparison of the uptake was performed, providing a correlation coefficient.

Results: All parameters of [(18)F]HX4 uptake were significantly correlated between scans: SUVmax (r = 0.958, p < 0.001), SUVmean (r = 0.946, p < 0.001), TBRmax (r = 0.962, p < 0.001) and HV1.2 (r = 0.995, p < 0.001). The relative coefficients of repeatability were 15 % (SUVmean), 17 % (SUVmax) and 17 % (TBRmax). Voxel-wise analysis of the spatial uptake pattern within the tumors provided an average correlation of 0.65 ± 0.14.

Conclusion: Repeated hypoxia PET scans with [(18)F]HX4 provide reproducible and spatially stable results in patients with head and neck cancer and patients with lung cancer. [(18)F]HX4 PET imaging can be used to assess the hypoxic status of tumors and has the potential to aid hypoxia-targeted treatments.

No MeSH data available.


Related in: MedlinePlus