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
2011 Impact Factor: 2.775
2011 SCImago Journal Rankings: 0.229
DOIhttp://dx.doi.org/10.2214/AJR.11.7336
DC Field
Value
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
2011 Impact Factor: 2.775
2011 SCImago Journal Rankings: 0.229
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
Author Affiliations
  1. The University of Hong Kong