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Article: Nasopharyngeal carcinoma: investigation of intratumoral heterogeneity with FDG PET/CT
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TitleNasopharyngeal carcinoma: investigation of intratumoral heterogeneity with FDG PET/CT
 
AuthorsHuang, B1
Chan, T1
Kwong, DLW1
Chan, WKS1
Khong, PL1
 
KeywordsDisease-free survival
Nasopharyngeal carcinoma
PET/CT
Tumor heterogeneity
 
Issue Date2012
 
PublisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfm
 
CitationAmerican Journal of Roentgenology, 2012, v. 199 n. 1, p. 169-174 [How to Cite?]
DOI: http://dx.doi.org/10.2214/AJR.11.7336
 
AbstractOBJECTIVE: The purpose of this study was to quantitatively evaluate the role of intratumoral heterogeneity of (18)F-FDG uptake in characterizing nasopharyngeal carcinoma (NPC). SUBJECTS AND METHODS: Forty consecutively registered patients with newly diagnosed NPC underwent PET/CT. The heterogeneity factor, defined as the derivative of a volume threshold function, was computed for each tumor. The relations between heterogeneity factor and maximum standardized uptake value (SUV(max)), tumor volume, and TNM category were determined by two-tailed Spearman correlation. Factors that potentially affect outcome determined by disease-free survival were studied by Kaplan-Meier analysis with a log-rank test for univariate analysis and the Cox proportional hazard model for multivariate analysis. RESULTS: The heterogeneity factor ranged from -1.80 to -0.13 (mean, -0.40 [SD, 0.40]) and significantly correlated with SUV(max) (r = -0.372; p = 0.018), tumor volume (r = -0.983; p < 0.001), and T category (r = -0.457; p = 0.003) but not with N and M categories. There was a significant difference in heterogeneity factor between T1 and T2 tumors and T3 and T4 tumors (p = 0.012). The 2-year disease-free survival rate among the 38 patients was 67.4%. According to the results of Kaplan-Meier analysis with the log-rank test, heterogeneity factor and M category significantly affected disease-free survival. Patients with tumors that had a heterogeneity factor greater than -0.24 (less-heterogeneous group) (p = 0.0498) or M0 status (p < 0.001) had better disease-free survival rates. Multivariate analysis showed only M category to be an independent predictor of disease-free survival (p < 0.001). CONCLUSION: The intratumoral heterogeneity of FDG uptake varies across NPC tumors, significantly correlates with tumor aggressiveness, and is predictive of patient outcome. These findings may be useful for characterizing NPC, predicting survival, and improving patient care. © American Roentgen Ray Society.
 
DescriptionNuclear medicine and molecular imaging: Original research
Open Access Journal
 
ISSN0361-803X
2013 Impact Factor: 2.744
 
DOIhttp://dx.doi.org/10.2214/AJR.11.7336
 
DC FieldValue
dc.contributor.authorHuang, B
 
dc.contributor.authorChan, T
 
dc.contributor.authorKwong, DLW
 
dc.contributor.authorChan, WKS
 
dc.contributor.authorKhong, PL
 
dc.date.accessioned2012-09-20T07:53:09Z
 
dc.date.available2012-09-20T07:53:09Z
 
dc.date.issued2012
 
dc.description.abstractOBJECTIVE: The purpose of this study was to quantitatively evaluate the role of intratumoral heterogeneity of (18)F-FDG uptake in characterizing nasopharyngeal carcinoma (NPC). SUBJECTS AND METHODS: Forty consecutively registered patients with newly diagnosed NPC underwent PET/CT. The heterogeneity factor, defined as the derivative of a volume threshold function, was computed for each tumor. The relations between heterogeneity factor and maximum standardized uptake value (SUV(max)), tumor volume, and TNM category were determined by two-tailed Spearman correlation. Factors that potentially affect outcome determined by disease-free survival were studied by Kaplan-Meier analysis with a log-rank test for univariate analysis and the Cox proportional hazard model for multivariate analysis. RESULTS: The heterogeneity factor ranged from -1.80 to -0.13 (mean, -0.40 [SD, 0.40]) and significantly correlated with SUV(max) (r = -0.372; p = 0.018), tumor volume (r = -0.983; p < 0.001), and T category (r = -0.457; p = 0.003) but not with N and M categories. There was a significant difference in heterogeneity factor between T1 and T2 tumors and T3 and T4 tumors (p = 0.012). The 2-year disease-free survival rate among the 38 patients was 67.4%. According to the results of Kaplan-Meier analysis with the log-rank test, heterogeneity factor and M category significantly affected disease-free survival. Patients with tumors that had a heterogeneity factor greater than -0.24 (less-heterogeneous group) (p = 0.0498) or M0 status (p < 0.001) had better disease-free survival rates. Multivariate analysis showed only M category to be an independent predictor of disease-free survival (p < 0.001). CONCLUSION: The intratumoral heterogeneity of FDG uptake varies across NPC tumors, significantly correlates with tumor aggressiveness, and is predictive of patient outcome. These findings may be useful for characterizing NPC, predicting survival, and improving patient care. © American Roentgen Ray Society.
 
dc.description.naturelink_to_OA_fulltext
 
dc.descriptionNuclear medicine and molecular imaging: Original research
 
dc.descriptionOpen Access Journal
 
dc.identifier.citationAmerican Journal of Roentgenology, 2012, v. 199 n. 1, p. 169-174 [How to Cite?]
DOI: http://dx.doi.org/10.2214/AJR.11.7336
 
dc.identifier.doihttp://dx.doi.org/10.2214/AJR.11.7336
 
dc.identifier.epage174
 
dc.identifier.hkuros206684
 
dc.identifier.issn0361-803X
2013 Impact Factor: 2.744
 
dc.identifier.issue1
 
dc.identifier.pmid22733909
 
dc.identifier.scopuseid_2-s2.0-84863642701
 
dc.identifier.spage169
 
dc.identifier.urihttp://hdl.handle.net/10722/163916
 
dc.identifier.volume199
 
dc.languageeng
 
dc.publisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfm
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAmerican Journal of Roentgenology
 
dc.subject.meshFluorodeoxyglucose F18 - diagnostic use - pharmacokinetics
 
dc.subject.meshNasopharyngeal neoplasms - metabolism - pathology - radionuclide imaging - therapy
 
dc.subject.meshNeoplasm invasiveness - pathology
 
dc.subject.meshPositron-emission tomography and computed tomography
 
dc.subject.meshRadiopharmaceuticals - diagnostic use - pharmacokinetics
 
dc.subject.meshAdolescent
 
dc.subject.meshAdult
 
dc.subject.meshAged
 
dc.subject.meshAged, 80 and over
 
dc.subject.meshCell differentiation
 
dc.subject.meshChemoradiotherapy
 
dc.subject.meshFemale
 
dc.subject.meshFollow-up studies
 
dc.subject.meshHumans
 
dc.subject.meshMale
 
dc.subject.meshMiddle aged
 
dc.subject.meshMultivariate analysis
 
dc.subject.meshNeoplasm staging
 
dc.subject.meshPredictive value of tests
 
dc.subject.meshTreatment outcome
 
dc.subject.meshTumor burden
 
dc.subject.meshYoung adult
 
dc.subjectDisease-free survival
 
dc.subjectNasopharyngeal carcinoma
 
dc.subjectPET/CT
 
dc.subjectTumor heterogeneity
 
dc.titleNasopharyngeal carcinoma: investigation of intratumoral heterogeneity with FDG PET/CT
 
dc.typeArticle
 
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<contributor.author>Chan, T</contributor.author>
<contributor.author>Kwong, DLW</contributor.author>
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<contributor.author>Khong, PL</contributor.author>
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Author Affiliations
  1. The University of Hong Kong