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01.09.2014 | Head and Neck

Asphericity of pretherapeutic tumour FDG uptake provides independent prognostic value in head-and-neck cancer

verfasst von: Ivayla Apostolova, Ingo G. Steffen, Florian Wedel, Alexandr Lougovski, Simone Marnitz, Thorsten Derlin, Holger Amthauer, Ralph Buchert, Frank Hofheinz, Winfried Brenner

Erschienen in: European Radiology | Ausgabe 9/2014

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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, SUV_max, SUV_mean, 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 SUV_max [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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Titel: Asphericity of pretherapeutic tumour FDG uptake provides independent prognostic value in head-and-neck cancer
verfasst von: Ivayla Apostolova
Ingo G. Steffen
Florian Wedel
Alexandr Lougovski
Simone Marnitz
Thorsten Derlin
Holger Amthauer
Ralph Buchert
Frank Hofheinz
Winfried Brenner
Publikationsdatum: 01.09.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3269-8

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Asphericity of pretherapeutic tumour FDG uptake provides independent prognostic value in head-and-neck cancer

Abstract

Objective

Methods

Results

Conclusions

Key Points

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Objective

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