Asphericity of pretherapeutic tumour FDG uptake provides independent prognostic value in head-and-neck cancer |
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Authors: | Ivayla Apostolova Ingo G. Steffen Florian Wedel Alexandr Lougovski Simone Marnitz Thorsten Derlin Holger Amthauer Ralph Buchert Frank Hofheinz Winfried Brenner |
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Affiliation: | 1. Department of Nuclear Medicine, Charité University Medical Center, Berlin, Germany 5. Department of Radiology and Nuclear Medicine, Otto-von-Guericke University Clinic Magdeburg, Leipziger Str. 44, 30120, Magdeburg, Germany 4. Institute of Radiopharmaceutical Cancer Research, Helmholtz Center Dresden Rossendorf, Dresden, Germany 2. Department of Radiooncology, Charité University Medical Center, Berlin, Germany 3. Department of Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Abstract: | Objective To propose a novel measure, namely the ‘asphericity’ (ASP), of spatial irregularity of FDG uptake in the primary tumour as a prognostic marker in head-and-neck cancer. Methods PET/CT was performed in 52 patients (first presentation, n?=?36; recurrence, n?=?16). The primary tumour was segmented based on thresholding at the volume-reproducible intensity threshold after subtraction of the local background. ASP was used to characterise the deviation of the tumour’s shape from sphere symmetry. Tumour stage, tumour localisation, lymph node metastases, distant metastases, SUVmax, SUVmean, metabolic tumour volume (MTV) and total lesion glycolysis (TLG) were also considered. The association of overall (OAS) and progression-free survival (PFS) with these parameters was analysed. Results Cox regression revealed high SUVmax [hazard ratio (HR)?=?4.4/7.4], MTV (HR?=?4.6/5.7), TLG (HR?=?4.8/8.9) and ASP (HR?=?7.8/7.4) as significant predictors with respect to PFS/OAS in case of first tumour manifestation. The combination of high MTV and ASP showed very high HRs of 22.7 for PFS and 13.2 for OAS. In case of recurrence, MTV (HR?=?3.7) and the combination of MTV/ASP (HR?=?4.2) were significant predictors of PFS. Conclusions ASP of pretherapeutic FDG uptake in the primary tumour improves the prediction of tumour progression in head-and-neck cancer at first tumour presentation. Key Points ?Asphericity (ASP) characterises the spatial heterogeneity of FDG uptake in tumours ? ASP is a promising prognostic parameter in head-and-neck cancer ? ASP is useful for identification of high-risk patients with head-and-neck cancer |
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