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Article: Nasopharyngeal carcinoma: investigation of intratumoral heterogeneity with FDG PET/CT

TitleNasopharyngeal carcinoma: investigation of intratumoral heterogeneity with FDG PET/CT
Authors
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
Citation
American Journal of Roentgenology, 2012, v. 199 n. 1, p. 169-174 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/163916
ISSN
2014 Impact Factor: 2.731
2014 SCImago Journal Rankings: 1.510
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorHuang, Ben_US
dc.contributor.authorChan, Ten_US
dc.contributor.authorKwong, DLWen_US
dc.contributor.authorChan, WKSen_US
dc.contributor.authorKhong, PLen_US
dc.date.accessioned2012-09-20T07:53:09Z-
dc.date.available2012-09-20T07:53:09Z-
dc.date.issued2012en_US
dc.identifier.citationAmerican Journal of Roentgenology, 2012, v. 199 n. 1, p. 169-174en_US
dc.identifier.issn0361-803X-
dc.identifier.urihttp://hdl.handle.net/10722/163916-
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.languageengen_US
dc.publisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfm-
dc.relation.ispartofAmerican Journal of Roentgenologyen_US
dc.subjectDisease-free survival-
dc.subjectNasopharyngeal carcinoma-
dc.subjectPET/CT-
dc.subjectTumor heterogeneity-
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.titleNasopharyngeal carcinoma: investigation of intratumoral heterogeneity with FDG PET/CTen_US
dc.typeArticleen_US
dc.identifier.emailHuang, B: huanghku@hku.hken_US
dc.identifier.emailChan, T: taochan@hku.hken_US
dc.identifier.emailKwong, DLW: dlwkwong@hku.hken_US
dc.identifier.emailChan, WKS: kitsum80@hkucc.hku.hken_US
dc.identifier.emailKhong, PL: plkhong@hkucc.hku.hken_US
dc.identifier.authorityChan, T=rp00289en_US
dc.identifier.authorityKwong, DLW=rp00414en_US
dc.identifier.authorityKhong, PL=rp00467en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.2214/AJR.11.7336-
dc.identifier.pmid22733909-
dc.identifier.scopuseid_2-s2.0-84863642701-
dc.identifier.hkuros206684en_US
dc.identifier.volume199en_US
dc.identifier.issue1-
dc.identifier.spage169en_US
dc.identifier.epage174en_US
dc.identifier.isiWOS:000305804000046-
dc.publisher.placeUnited States-

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