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Parametric Response Mapping of Coregistered Positron Emission Tomography and Dynamic Contrast Enhanced Computed Tomography to Identify Radioresistant Subvolumes in Locally Advanced Cervical Cancer
- Source :
- International Journal of Radiation Oncology*Biology*Physics. 107:756-765
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Purpose To identify subvolumes that may predict treatment response to definitive concurrent chemoradiation therapy using parametric response mapping (PRM) of coregistered positron emission tomography (PET) and dynamic contrast-enhanced (DCE) computed tomography (CT) in locally advanced cervical carcinoma. Methods and Materials Pre- and midtreatment (after 23 ± 4 days of concurrent chemoradiation therapy) DCE CT and PET imaging were performed on 21 patients with cervical cancer who were enrolled in a pilot study to evaluate the prognostic value of CT perfusion for primary cervical cancer (NCT01805141). Three-dimensional coregistered maps of PET/CT standardized uptake value (SUV) and DCE CT blood flow (BF) were generated. PRM was performed using voxel-wise joint histogram analysis to classify voxels within the tumor as highly metabolic and perfused (SUVhiBFhi), highly metabolic and hypoxic (SUVhiBFlo), low metabolic activity and hypoxic (SUVloBFlo), or low metabolic activity and perfused (SUVloBFhi) tissue based on thresholds determined from population means of pretreatment PET SUV and DCE CT BF. Relationships between baseline pretreatment imaging metrics and relative changes in metabolic tumor volume (ΔMTV), calculated from before treatment and during treatment imaging, were determined using univariable and multivariable linear regression models. Results The relative volume of three PRM subvolumes significantly changed during treatment (SUVhiBFhi: P = .04; SUVhiBFlo: P = .0008; SUVloBFhi: P = .02), whereas SUVloBFlo did not (P = .9). Pretreatment PET SUVmax (r = −.58, P = .006), PET SUVmean (ρ = −.59, P = .005), DCE CT BFmean (r = −.50, P = .02), tumor volume (ρ = −.65, P = .001) and PRM SUVhiBFhi (ρ = −.59, P = .004) were negatively correlated with ΔMTV, whereas PRM SUVloBFlo was positively related to ΔMTV (r = .77, P Conclusions PRM was applied in locally advanced cervical carcinoma treated definitively with chemoradiation, and radioresistant subvolumes were identified that correlated with changes in MTV and predicted treatment response. Identification of these subvolumes may assist in clinical decision making to tailor therapies, such as brachytherapy, in an effort to improve patient outcomes.
- Subjects :
- Cancer Research
medicine.medical_treatment
Brachytherapy
Population
Uterine Cervical Neoplasms
Perfusion scanning
Standardized uptake value
Signal-To-Noise Ratio
computer.software_genre
Radiation Tolerance
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Voxel
Positron Emission Tomography Computed Tomography
Image Processing, Computer-Assisted
medicine
Humans
Radiology, Nuclear Medicine and imaging
education
Cervical cancer
education.field_of_study
Radiation
medicine.diagnostic_test
business.industry
Blood flow
Middle Aged
medicine.disease
Oncology
Positron emission tomography
030220 oncology & carcinogenesis
Female
Nuclear medicine
business
computer
Subjects
Details
- ISSN :
- 03603016
- Volume :
- 107
- Database :
- OpenAIRE
- Journal :
- International Journal of Radiation Oncology*Biology*Physics
- Accession number :
- edsair.doi.dedup.....311ffa702686933b746aeff5f41c3320