Prognostic value of baseline [18F]-fluorodeoxyglucose positron emission tomography parameters MTV, TLG and asphericity in an international multicenter cohort of nasopharyngeal carcinoma patients
Purpose [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) parameters have shown prognostic value in nasopharyngeal carcinomas (NPC), mostly in monocenter studies. The aim of this study was to assess the prognostic impact of standard and novel PET parameters in a multicenter cohort of...
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| creator | Zschaeck, Sebastian Li, Yimin Lin, Qin Beck, Marcus Amthauer, Holger Bauersachs, Laura Hajiyianni, Marina Rogasch, Julian Ehrhardt, Vincent H. Kalinauskaite, Goda Weingärtner, Julian Hartmann, Vivian van den Hoff, Jörg Budach, Volker Stromberger, Carmen Hofheinz, Frank |
| description | Purpose [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) parameters have shown prognostic value in nasopharyngeal carcinomas (NPC), mostly in monocenter studies. The aim of this study was to assess the prognostic impact of standard and novel PET parameters in a multicenter cohort of patients. Methods The established PET parameters metabolic tumor volume (MTV), total lesion glycolysis (TLG) and maximal standardized uptake value (SUVmax) as well as the novel parameter tumor asphericity (ASP) were evaluated in a retrospective multicenter cohort of 114 NPC patients with FDG-PET staging, treated with (chemo)radiation at 8 international institutions. Uni- and multivariable Cox regression and Kaplan-Meier analysis with respect to overall survival (OS), event-free survival (EFS), distant metastases-free survival (FFDM), and locoregional control (LRC) was performed for clinical and PET parameters. Results When analyzing metric PET parameters, ASP showed a significant association with EFS (p = 0.035) and a trend for OS (p = 0.058). MTV was significantly associated with EFS (p = 0.026), OS (p = 0.008) and LRC (p = 0.012) and TLG with LRC (p = 0.019). TLG and MTV showed a very high correlation (Spearman’s rho = 0.95), therefore TLG was subesequently not further analysed. Optimal cutoff values for defining high and low risk groups were determined by maximization of the p-value in univariate Cox regression considering all possible cutoff values. Generation of stable cutoff values was feasible for MTV (p |
| doi_str_mv | 10.1371/journal.pone.0236841 |
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The aim of this study was to assess the prognostic impact of standard and novel PET parameters in a multicenter cohort of patients. Methods The established PET parameters metabolic tumor volume (MTV), total lesion glycolysis (TLG) and maximal standardized uptake value (SUVmax) as well as the novel parameter tumor asphericity (ASP) were evaluated in a retrospective multicenter cohort of 114 NPC patients with FDG-PET staging, treated with (chemo)radiation at 8 international institutions. Uni- and multivariable Cox regression and Kaplan-Meier analysis with respect to overall survival (OS), event-free survival (EFS), distant metastases-free survival (FFDM), and locoregional control (LRC) was performed for clinical and PET parameters. Results When analyzing metric PET parameters, ASP showed a significant association with EFS (p = 0.035) and a trend for OS (p = 0.058). MTV was significantly associated with EFS (p = 0.026), OS (p = 0.008) and LRC (p = 0.012) and TLG with LRC (p = 0.019). TLG and MTV showed a very high correlation (Spearman’s rho = 0.95), therefore TLG was subesequently not further analysed. Optimal cutoff values for defining high and low risk groups were determined by maximization of the p-value in univariate Cox regression considering all possible cutoff values. Generation of stable cutoff values was feasible for MTV (p<0.001), ASP (p = 0.023) and combination of both (MTV+ASP = occurrence of one or both risk factors, p<0.001) for OS and for MTV regarding the endpoints OS (p<0.001) and LRC (p<0.001). In multivariable Cox (age >55 years + one binarized PET parameter), MTV >11.1ml (hazard ratio (HR): 3.57, p<0.001) and ASP > 14.4% (HR: 3.2, p = 0.031) remained prognostic for OS. MTV additionally remained prognostic for LRC (HR: 4.86 p<0.001) and EFS (HR: 2.51 p = 0.004). Bootstrapping analyses showed that a combination of high MTV and ASP improved prognostic value for OS compared to each single variable significantly (p = 0.005 and p = 0.04, respectively). When using the cohort from China (n = 57 patients) for establishment of prognostic parameters and all other patients for validation (n = 57 patients), MTV could be successfully validated as prognostic parameter regarding OS, EFS and LRC (all p-values <0.05 for both cohorts). Conclusions In this analysis, PET parameters were associated with outcome of NPC patients. MTV showed a robust association with OS, EFS and LRC. Our data suggest that combination of MTV and ASP may potentially further improve the risk stratification of NPC patients.]]></description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0236841</identifier><identifier>PMID: 32730364</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Archives & records ; Asphericity ; Biology and Life Sciences ; Cancer therapies ; Chemotherapy ; Drug dosages ; Emissions ; Fluorine isotopes ; Glycolysis ; Head & neck cancer ; Medical prognosis ; Medical research ; Medicine and Health Sciences ; Metastases ; Nasopharyngeal carcinoma ; Nuclear medicine ; Oncology ; Optimization ; Parameters ; Patients ; Positron emission ; Positron emission tomography ; Radiation ; Radiation therapy ; Regression analysis ; Research and Analysis Methods ; Risk analysis ; Risk factors ; Risk groups ; Squamous cell carcinoma ; Survival ; Throat cancer ; Tomography ; Tumors</subject><ispartof>PloS one, 2020-07, Vol.15 (7), p.e0236841-e0236841</ispartof><rights>2020 Zschaeck et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Zschaeck et al 2020 Zschaeck et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-6a199fa7ffb18645fe168799eb1e7e85bd3b42e43848e8983b9c4bf5558ad34a3</citedby><cites>FETCH-LOGICAL-c503t-6a199fa7ffb18645fe168799eb1e7e85bd3b42e43848e8983b9c4bf5558ad34a3</cites><orcidid>0000-0003-3109-0662</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392321/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392321/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids></links><search><contributor>Albano, Domenico</contributor><creatorcontrib>Zschaeck, Sebastian</creatorcontrib><creatorcontrib>Li, Yimin</creatorcontrib><creatorcontrib>Lin, Qin</creatorcontrib><creatorcontrib>Beck, Marcus</creatorcontrib><creatorcontrib>Amthauer, Holger</creatorcontrib><creatorcontrib>Bauersachs, Laura</creatorcontrib><creatorcontrib>Hajiyianni, Marina</creatorcontrib><creatorcontrib>Rogasch, Julian</creatorcontrib><creatorcontrib>Ehrhardt, Vincent H.</creatorcontrib><creatorcontrib>Kalinauskaite, Goda</creatorcontrib><creatorcontrib>Weingärtner, Julian</creatorcontrib><creatorcontrib>Hartmann, Vivian</creatorcontrib><creatorcontrib>van den Hoff, Jörg</creatorcontrib><creatorcontrib>Budach, Volker</creatorcontrib><creatorcontrib>Stromberger, Carmen</creatorcontrib><creatorcontrib>Hofheinz, Frank</creatorcontrib><title>Prognostic value of baseline [18F]-fluorodeoxyglucose positron emission tomography parameters MTV, TLG and asphericity in an international multicenter cohort of nasopharyngeal carcinoma patients</title><title>PloS one</title><description><![CDATA[Purpose [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) parameters have shown prognostic value in nasopharyngeal carcinomas (NPC), mostly in monocenter studies. The aim of this study was to assess the prognostic impact of standard and novel PET parameters in a multicenter cohort of patients. Methods The established PET parameters metabolic tumor volume (MTV), total lesion glycolysis (TLG) and maximal standardized uptake value (SUVmax) as well as the novel parameter tumor asphericity (ASP) were evaluated in a retrospective multicenter cohort of 114 NPC patients with FDG-PET staging, treated with (chemo)radiation at 8 international institutions. Uni- and multivariable Cox regression and Kaplan-Meier analysis with respect to overall survival (OS), event-free survival (EFS), distant metastases-free survival (FFDM), and locoregional control (LRC) was performed for clinical and PET parameters. Results When analyzing metric PET parameters, ASP showed a significant association with EFS (p = 0.035) and a trend for OS (p = 0.058). MTV was significantly associated with EFS (p = 0.026), OS (p = 0.008) and LRC (p = 0.012) and TLG with LRC (p = 0.019). TLG and MTV showed a very high correlation (Spearman’s rho = 0.95), therefore TLG was subesequently not further analysed. Optimal cutoff values for defining high and low risk groups were determined by maximization of the p-value in univariate Cox regression considering all possible cutoff values. Generation of stable cutoff values was feasible for MTV (p<0.001), ASP (p = 0.023) and combination of both (MTV+ASP = occurrence of one or both risk factors, p<0.001) for OS and for MTV regarding the endpoints OS (p<0.001) and LRC (p<0.001). In multivariable Cox (age >55 years + one binarized PET parameter), MTV >11.1ml (hazard ratio (HR): 3.57, p<0.001) and ASP > 14.4% (HR: 3.2, p = 0.031) remained prognostic for OS. MTV additionally remained prognostic for LRC (HR: 4.86 p<0.001) and EFS (HR: 2.51 p = 0.004). Bootstrapping analyses showed that a combination of high MTV and ASP improved prognostic value for OS compared to each single variable significantly (p = 0.005 and p = 0.04, respectively). When using the cohort from China (n = 57 patients) for establishment of prognostic parameters and all other patients for validation (n = 57 patients), MTV could be successfully validated as prognostic parameter regarding OS, EFS and LRC (all p-values <0.05 for both cohorts). Conclusions In this analysis, PET parameters were associated with outcome of NPC patients. MTV showed a robust association with OS, EFS and LRC. Our data suggest that combination of MTV and ASP may potentially further improve the risk stratification of NPC patients.]]></description><subject>Archives & records</subject><subject>Asphericity</subject><subject>Biology and Life Sciences</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Drug dosages</subject><subject>Emissions</subject><subject>Fluorine isotopes</subject><subject>Glycolysis</subject><subject>Head & neck cancer</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Metastases</subject><subject>Nasopharyngeal carcinoma</subject><subject>Nuclear medicine</subject><subject>Oncology</subject><subject>Optimization</subject><subject>Parameters</subject><subject>Patients</subject><subject>Positron emission</subject><subject>Positron emission tomography</subject><subject>Radiation</subject><subject>Radiation therapy</subject><subject>Regression 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value of baseline [18F]-fluorodeoxyglucose positron emission tomography parameters MTV, TLG and asphericity in an international multicenter cohort of nasopharyngeal carcinoma patients</title><author>Zschaeck, Sebastian ; Li, Yimin ; Lin, Qin ; Beck, Marcus ; Amthauer, Holger ; Bauersachs, Laura ; Hajiyianni, Marina ; Rogasch, Julian ; Ehrhardt, Vincent H. ; Kalinauskaite, Goda ; Weingärtner, Julian ; Hartmann, Vivian ; van den Hoff, Jörg ; Budach, Volker ; Stromberger, Carmen ; Hofheinz, Frank</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-6a199fa7ffb18645fe168799eb1e7e85bd3b42e43848e8983b9c4bf5558ad34a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Archives & records</topic><topic>Asphericity</topic><topic>Biology and Life Sciences</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Drug dosages</topic><topic>Emissions</topic><topic>Fluorine isotopes</topic><topic>Glycolysis</topic><topic>Head & neck cancer</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Metastases</topic><topic>Nasopharyngeal carcinoma</topic><topic>Nuclear medicine</topic><topic>Oncology</topic><topic>Optimization</topic><topic>Parameters</topic><topic>Patients</topic><topic>Positron emission</topic><topic>Positron emission tomography</topic><topic>Radiation</topic><topic>Radiation therapy</topic><topic>Regression analysis</topic><topic>Research and Analysis Methods</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Risk groups</topic><topic>Squamous cell carcinoma</topic><topic>Survival</topic><topic>Throat cancer</topic><topic>Tomography</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zschaeck, Sebastian</creatorcontrib><creatorcontrib>Li, Yimin</creatorcontrib><creatorcontrib>Lin, 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one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zschaeck, Sebastian</au><au>Li, Yimin</au><au>Lin, Qin</au><au>Beck, Marcus</au><au>Amthauer, Holger</au><au>Bauersachs, Laura</au><au>Hajiyianni, Marina</au><au>Rogasch, Julian</au><au>Ehrhardt, Vincent H.</au><au>Kalinauskaite, Goda</au><au>Weingärtner, Julian</au><au>Hartmann, Vivian</au><au>van den Hoff, Jörg</au><au>Budach, Volker</au><au>Stromberger, Carmen</au><au>Hofheinz, Frank</au><au>Albano, Domenico</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of baseline [18F]-fluorodeoxyglucose positron emission tomography parameters MTV, TLG and asphericity in an international multicenter cohort of nasopharyngeal carcinoma patients</atitle><jtitle>PloS one</jtitle><date>2020-07-30</date><risdate>2020</risdate><volume>15</volume><issue>7</issue><spage>e0236841</spage><epage>e0236841</epage><pages>e0236841-e0236841</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract><![CDATA[Purpose [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) parameters have shown prognostic value in nasopharyngeal carcinomas (NPC), mostly in monocenter studies. The aim of this study was to assess the prognostic impact of standard and novel PET parameters in a multicenter cohort of patients. Methods The established PET parameters metabolic tumor volume (MTV), total lesion glycolysis (TLG) and maximal standardized uptake value (SUVmax) as well as the novel parameter tumor asphericity (ASP) were evaluated in a retrospective multicenter cohort of 114 NPC patients with FDG-PET staging, treated with (chemo)radiation at 8 international institutions. Uni- and multivariable Cox regression and Kaplan-Meier analysis with respect to overall survival (OS), event-free survival (EFS), distant metastases-free survival (FFDM), and locoregional control (LRC) was performed for clinical and PET parameters. Results When analyzing metric PET parameters, ASP showed a significant association with EFS (p = 0.035) and a trend for OS (p = 0.058). MTV was significantly associated with EFS (p = 0.026), OS (p = 0.008) and LRC (p = 0.012) and TLG with LRC (p = 0.019). TLG and MTV showed a very high correlation (Spearman’s rho = 0.95), therefore TLG was subesequently not further analysed. Optimal cutoff values for defining high and low risk groups were determined by maximization of the p-value in univariate Cox regression considering all possible cutoff values. Generation of stable cutoff values was feasible for MTV (p<0.001), ASP (p = 0.023) and combination of both (MTV+ASP = occurrence of one or both risk factors, p<0.001) for OS and for MTV regarding the endpoints OS (p<0.001) and LRC (p<0.001). In multivariable Cox (age >55 years + one binarized PET parameter), MTV >11.1ml (hazard ratio (HR): 3.57, p<0.001) and ASP > 14.4% (HR: 3.2, p = 0.031) remained prognostic for OS. MTV additionally remained prognostic for LRC (HR: 4.86 p<0.001) and EFS (HR: 2.51 p = 0.004). Bootstrapping analyses showed that a combination of high MTV and ASP improved prognostic value for OS compared to each single variable significantly (p = 0.005 and p = 0.04, respectively). When using the cohort from China (n = 57 patients) for establishment of prognostic parameters and all other patients for validation (n = 57 patients), MTV could be successfully validated as prognostic parameter regarding OS, EFS and LRC (all p-values <0.05 for both cohorts). Conclusions In this analysis, PET parameters were associated with outcome of NPC patients. MTV showed a robust association with OS, EFS and LRC. Our data suggest that combination of MTV and ASP may potentially further improve the risk stratification of NPC patients.]]></abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32730364</pmid><doi>10.1371/journal.pone.0236841</doi><orcidid>https://orcid.org/0000-0003-3109-0662</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-07, Vol.15 (7), p.e0236841-e0236841 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Archives & records Asphericity Biology and Life Sciences Cancer therapies Chemotherapy Drug dosages Emissions Fluorine isotopes Glycolysis Head & neck cancer Medical prognosis Medical research Medicine and Health Sciences Metastases Nasopharyngeal carcinoma Nuclear medicine Oncology Optimization Parameters Patients Positron emission Positron emission tomography Radiation Radiation therapy Regression analysis Research and Analysis Methods Risk analysis Risk factors Risk groups Squamous cell carcinoma Survival Throat cancer Tomography Tumors |
| title | Prognostic value of baseline [18F]-fluorodeoxyglucose positron emission tomography parameters MTV, TLG and asphericity in an international multicenter cohort of nasopharyngeal carcinoma patients |
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