Multiparametric Imaging Using F-FDG PET/CT Heterogeneity Parameters and Functional MRI Techniques: Prognostic Significance in Patients with Primary Advanced Oropharyngeal or Hypopharyngeal Squamous Cell Carcinoma Treated with Chemoradiotherapy

Overview

Journal Oncotarget

Specialty Oncology

Date 2017 Oct 6

PMID 28977973

Citations 16

Authors

Sheng-Chieh Chan

Nai-Ming Cheng

Chia-Hsun Hsieh

Shu-Hang Ng

Chien-Yu Lin

Tzu-Chen Yen

Cheng-Lung Hsu

Hung-Ming Wan

Chun-Ta Liao

Kai-Ping Chang

Jiun-Jie Wang

Affiliations

Soon will be listed here.

Abstract

Background: In this study, PET heterogeneity was combined with functional MRI techniques to refine the prediction of prognosis in patients with oropharyngeal or hypopharyngeal squamous cell carcinoma (OHSCC).

Methods: A total of 124 patients with primary advanced OHSCC who underwent pretreatment F-FDG PET/CT, dynamic contrast-enhanced MR imaging (DCE-MRI), and diffusion-weighted MR imaging (DWI) were enrolled. Conventional and heterogeneity parameters from F-FDG PET as well as perfusion parameters from DCE-MRI and diffusion parameter from DWI of primary tumors were analyzed in relation to recurrence-free survival (RFS) and overall survival (OS).

Results: Multivariate analysis identified hypopharyngeal tumors ( = 0.038), alcohol drinking ( = 0.006), K ≤ 0.5512 ( = 0.017), and K ≤ 0.8872 ( = 0.005) as adverse prognostic factors for RFS. Smoking ( = 0.009), K ≤ 0.5512 ( = 0.0002), K ≤ 0.8872 ( = 0.004), and the PET heterogeneity parameter uniformity ≤ 0.00381 ( = 0.028) were independent predictors of poor OS. The combination of PET uniformity with DCE-MRI parameters and smoking allowed distinguishing four prognostic groups, with 3-year OS rates of 100%, 76.6%, 57.4%, and 7.1%, respectively ( < 0.0001). This prognostic system appeared superior to both the TNM staging system ( = 0.186) and the combination of conventional PET parameters with DCE-MRI ( = 0.004).

Conclusions: Multiparametric imaging based on PET heterogeneity and DCE-MRI parameters combined with clinical risk factors is superior to the concomitant use of functional MRI coupled with conventional PET parameters. This approach may improve the prognostic stratification of OHSCC patients.

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