Pilot study of combined FDG-PET and dynamic contrast-enhanced CT of locally advanced cervical carcinoma before and during concurrent chemoradiotherapy suggests association between changes in tumor blood volume and treatment response

Thomas I. Banks; Rie von Eyben; Dimitre Hristov; Elizabeth A. Kidd

doi:10.1002/cam4.1632

Pilot study of combined FDG-PET and dynamic contrast-enhanced CT of locally advanced cervical carcinoma before and during concurrent chemoradiotherapy suggests association between changes in tumor blood volume and treatment response

Thomas I. Banks, Rie von Eyben, Dimitre Hristov, Elizabeth A. Kidd

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Modern PET/CT radiotherapy simulators offer FDG-PET and dynamic contrast-enhanced (DCE) CT imaging for combined volumetric assessment of tumor metabolism and perfusion. However, the clinical utility of such assessment has not been clearly defined. Thus, in a prospective longitudinal study of primary cervical tumors treated with concurrent chemoradiotherapy (CCRT) we evaluated: (1) whether PET and perfusion parameters correlate or provide complementary information; (2) what imaging changes occur during CCRT; and (3) whether any parameters are predictive of treatment response as assessed by PET/CT 3 months posttherapy. FDG-PET/CT and DCE-CT scans were performed on 21 patients prior to and during CCRT. Coregistered volumetric parametric maps of standardized uptake value (SUV) measures and perfusion parameters blood flow (BF), blood volume (BV), and permeability were generated. Summary statistics for these parameters and their changes were calculated within the metabolic tumor volume (MTV). Correlations between SUV and BF/BV/permeability on local and global bases were assessed with Pearson's coefficient r. MTV, maximum SUV, and mean SUV decreased significantly between the pre- and during-treatment time points, while mean BV and permeability increased significantly. Global correlations between mean BF/BV/permeability and mean SUV values (−.15 < r <.29) were at most moderate. An increase in mean tumor BV during treatment was significantly correlated with complete metabolic response on 3-month posttreatment PET/CT. Weak correlations of SUV and perfusion parameters suggest a complementary role of FDG-PET and DCE-CT for tumor characterization. The association between relative change in mean BV and outcome suggests a potential role for DCE-CT in early evaluation of cervical tumor response to chemoradiotherapy.

Original language	English (US)
Pages (from-to)	3642-3651
Number of pages	10
Journal	Cancer Medicine
Volume	7
Issue number	8
DOIs	https://doi.org/10.1002/cam4.1632
State	Published - Aug 2018
Externally published	Yes

Keywords

DCE-CT
FDG-PET
blood flow
blood volume
cervical cancer
cervix cancer
perfusion
permeability
radiotherapy

ASJC Scopus subject areas

Oncology
Radiology Nuclear Medicine and imaging
Cancer Research

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Pilot study of combined FDG-PET and dynamic contrast-enhanced CT of locally advanced cervical carcinoma before and during concurrent chemoradiotherapy suggests association between changes in tumor blood volume and treatment response. / Banks, Thomas I.; von Eyben, Rie; Hristov, Dimitre et al.
In: Cancer Medicine, Vol. 7, No. 8, 08.2018, p. 3642-3651.

Research output: Contribution to journal › Article › peer-review

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title = "Pilot study of combined FDG-PET and dynamic contrast-enhanced CT of locally advanced cervical carcinoma before and during concurrent chemoradiotherapy suggests association between changes in tumor blood volume and treatment response",

abstract = "Modern PET/CT radiotherapy simulators offer FDG-PET and dynamic contrast-enhanced (DCE) CT imaging for combined volumetric assessment of tumor metabolism and perfusion. However, the clinical utility of such assessment has not been clearly defined. Thus, in a prospective longitudinal study of primary cervical tumors treated with concurrent chemoradiotherapy (CCRT) we evaluated: (1) whether PET and perfusion parameters correlate or provide complementary information; (2) what imaging changes occur during CCRT; and (3) whether any parameters are predictive of treatment response as assessed by PET/CT 3 months posttherapy. FDG-PET/CT and DCE-CT scans were performed on 21 patients prior to and during CCRT. Coregistered volumetric parametric maps of standardized uptake value (SUV) measures and perfusion parameters blood flow (BF), blood volume (BV), and permeability were generated. Summary statistics for these parameters and their changes were calculated within the metabolic tumor volume (MTV). Correlations between SUV and BF/BV/permeability on local and global bases were assessed with Pearson's coefficient r. MTV, maximum SUV, and mean SUV decreased significantly between the pre- and during-treatment time points, while mean BV and permeability increased significantly. Global correlations between mean BF/BV/permeability and mean SUV values (−.15 < r <.29) were at most moderate. An increase in mean tumor BV during treatment was significantly correlated with complete metabolic response on 3-month posttreatment PET/CT. Weak correlations of SUV and perfusion parameters suggest a complementary role of FDG-PET and DCE-CT for tumor characterization. The association between relative change in mean BV and outcome suggests a potential role for DCE-CT in early evaluation of cervical tumor response to chemoradiotherapy.",

keywords = "DCE-CT, FDG-PET, blood flow, blood volume, cervical cancer, cervix cancer, perfusion, permeability, radiotherapy",

author = "Banks, {Thomas I.} and {von Eyben}, Rie and Dimitre Hristov and Kidd, {Elizabeth A.}",

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AB - Modern PET/CT radiotherapy simulators offer FDG-PET and dynamic contrast-enhanced (DCE) CT imaging for combined volumetric assessment of tumor metabolism and perfusion. However, the clinical utility of such assessment has not been clearly defined. Thus, in a prospective longitudinal study of primary cervical tumors treated with concurrent chemoradiotherapy (CCRT) we evaluated: (1) whether PET and perfusion parameters correlate or provide complementary information; (2) what imaging changes occur during CCRT; and (3) whether any parameters are predictive of treatment response as assessed by PET/CT 3 months posttherapy. FDG-PET/CT and DCE-CT scans were performed on 21 patients prior to and during CCRT. Coregistered volumetric parametric maps of standardized uptake value (SUV) measures and perfusion parameters blood flow (BF), blood volume (BV), and permeability were generated. Summary statistics for these parameters and their changes were calculated within the metabolic tumor volume (MTV). Correlations between SUV and BF/BV/permeability on local and global bases were assessed with Pearson's coefficient r. MTV, maximum SUV, and mean SUV decreased significantly between the pre- and during-treatment time points, while mean BV and permeability increased significantly. Global correlations between mean BF/BV/permeability and mean SUV values (−.15 < r <.29) were at most moderate. An increase in mean tumor BV during treatment was significantly correlated with complete metabolic response on 3-month posttreatment PET/CT. Weak correlations of SUV and perfusion parameters suggest a complementary role of FDG-PET and DCE-CT for tumor characterization. The association between relative change in mean BV and outcome suggests a potential role for DCE-CT in early evaluation of cervical tumor response to chemoradiotherapy.

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Pilot study of combined FDG-PET and dynamic contrast-enhanced CT of locally advanced cervical carcinoma before and during concurrent chemoradiotherapy suggests association between changes in tumor blood volume and treatment response

Abstract

Keywords

ASJC Scopus subject areas

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