18F-FMISO-PET Hypoxia Monitoring for Head-and-Neck Cancer Patients: Radiomics Analyses Predict the Outcome of Chemo-Radiotherapy
Tumor hypoxia is associated with radiation resistance and can be longitudinally monitored by 18F-fluoromisonidazole (18F-FMISO)-PET/CT. Our study aimed at evaluating radiomics dynamics of 18F-FMISO-hypoxia imaging during chemo-radiotherapy (CRT) as predictors for treatment outcome in head-and-neck s...
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| Veröffentlicht in: | Cancers 2021-07, Vol.13 (14), p.3449 |
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| creator | Carles, Montserrat Fechter, Tobias Grosu, Anca L. Sörensen, Arnd Thomann, Benedikt Stoian, Raluca G. Wiedenmann, Nicole Rühle, Alexander Zamboglou, Constantinos Ruf, Juri Martí-Bonmatí, Luis Baltas, Dimos Mix, Michael Nicolay, Nils H. |
| description | Tumor hypoxia is associated with radiation resistance and can be longitudinally monitored by 18F-fluoromisonidazole (18F-FMISO)-PET/CT. Our study aimed at evaluating radiomics dynamics of 18F-FMISO-hypoxia imaging during chemo-radiotherapy (CRT) as predictors for treatment outcome in head-and-neck squamous cell carcinoma (HNSCC) patients. We prospectively recruited 35 HNSCC patients undergoing definitive CRT and longitudinal 18F-FMISO-PET/CT scans at weeks 0, 2 and 5 (W0/W2/W5). Patients were classified based on peritherapeutic variations of the hypoxic sub-volume (HSV) size (increasing/stable/decreasing) and location (geographically-static/geographically-dynamic) by a new objective classification parameter (CP) accounting for spatial overlap. Additionally, 130 radiomic features (RF) were extracted from HSV at W0, and their variations during CRT were quantified by relative deviations (∆RF). Prediction of treatment outcome was considered statistically relevant after being corrected for multiple testing and confirmed for the two 18F-FMISO-PET/CT time-points and for a validation cohort. HSV decreased in 64% of patients at W2 and in 80% at W5. CP distinguished earlier disease progression (geographically-dynamic) from later disease progression (geographically-static) in both time-points and cohorts. The texture feature low grey-level zone emphasis predicted local recurrence with AUCW2 = 0.82 and AUCW5 = 0.81 in initial cohort (N = 25) and AUCW2 = 0.79 and AUCW5 = 0.80 in validation cohort. Radiomics analysis of 18F-FMISO-derived hypoxia dynamics was able to predict outcome of HNSCC patients after CRT. |
| doi_str_mv | 10.3390/cancers13143449 |
| format | Article |
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Our study aimed at evaluating radiomics dynamics of 18F-FMISO-hypoxia imaging during chemo-radiotherapy (CRT) as predictors for treatment outcome in head-and-neck squamous cell carcinoma (HNSCC) patients. We prospectively recruited 35 HNSCC patients undergoing definitive CRT and longitudinal 18F-FMISO-PET/CT scans at weeks 0, 2 and 5 (W0/W2/W5). Patients were classified based on peritherapeutic variations of the hypoxic sub-volume (HSV) size (increasing/stable/decreasing) and location (geographically-static/geographically-dynamic) by a new objective classification parameter (CP) accounting for spatial overlap. Additionally, 130 radiomic features (RF) were extracted from HSV at W0, and their variations during CRT were quantified by relative deviations (∆RF). Prediction of treatment outcome was considered statistically relevant after being corrected for multiple testing and confirmed for the two 18F-FMISO-PET/CT time-points and for a validation cohort. HSV decreased in 64% of patients at W2 and in 80% at W5. CP distinguished earlier disease progression (geographically-dynamic) from later disease progression (geographically-static) in both time-points and cohorts. The texture feature low grey-level zone emphasis predicted local recurrence with AUCW2 = 0.82 and AUCW5 = 0.81 in initial cohort (N = 25) and AUCW2 = 0.79 and AUCW5 = 0.80 in validation cohort. Radiomics analysis of 18F-FMISO-derived hypoxia dynamics was able to predict outcome of HNSCC patients after CRT.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers13143449</identifier><identifier>PMID: 34298663</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Computed tomography ; Head and neck carcinoma ; Human papillomavirus ; Hypoxia ; Localization ; Metastases ; Metastasis ; Open source software ; Patients ; Radiation therapy ; Radiomics ; Squamous cell carcinoma ; Statistical analysis ; Variation</subject><ispartof>Cancers, 2021-07, Vol.13 (14), p.3449</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2439-35788fef5093bf45b00b081b9e7757820b6116a5411c83d5c40327c66b3061403</citedby><cites>FETCH-LOGICAL-c2439-35788fef5093bf45b00b081b9e7757820b6116a5411c83d5c40327c66b3061403</cites><orcidid>0000-0003-4220-9083 ; 0000-0002-9106-2519 ; 0000-0003-2022-897X ; 0000-0003-2550-1410 ; 0000-0001-6271-9385 ; 0000-0002-8234-010X ; 0000-0003-2401-8240</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/PMC8303992/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303992/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids></links><search><creatorcontrib>Carles, Montserrat</creatorcontrib><creatorcontrib>Fechter, Tobias</creatorcontrib><creatorcontrib>Grosu, Anca L.</creatorcontrib><creatorcontrib>Sörensen, Arnd</creatorcontrib><creatorcontrib>Thomann, Benedikt</creatorcontrib><creatorcontrib>Stoian, Raluca G.</creatorcontrib><creatorcontrib>Wiedenmann, Nicole</creatorcontrib><creatorcontrib>Rühle, Alexander</creatorcontrib><creatorcontrib>Zamboglou, Constantinos</creatorcontrib><creatorcontrib>Ruf, Juri</creatorcontrib><creatorcontrib>Martí-Bonmatí, Luis</creatorcontrib><creatorcontrib>Baltas, Dimos</creatorcontrib><creatorcontrib>Mix, Michael</creatorcontrib><creatorcontrib>Nicolay, Nils H.</creatorcontrib><title>18F-FMISO-PET Hypoxia Monitoring for Head-and-Neck Cancer Patients: Radiomics Analyses Predict the Outcome of Chemo-Radiotherapy</title><title>Cancers</title><description>Tumor hypoxia is associated with radiation resistance and can be longitudinally monitored by 18F-fluoromisonidazole (18F-FMISO)-PET/CT. Our study aimed at evaluating radiomics dynamics of 18F-FMISO-hypoxia imaging during chemo-radiotherapy (CRT) as predictors for treatment outcome in head-and-neck squamous cell carcinoma (HNSCC) patients. We prospectively recruited 35 HNSCC patients undergoing definitive CRT and longitudinal 18F-FMISO-PET/CT scans at weeks 0, 2 and 5 (W0/W2/W5). Patients were classified based on peritherapeutic variations of the hypoxic sub-volume (HSV) size (increasing/stable/decreasing) and location (geographically-static/geographically-dynamic) by a new objective classification parameter (CP) accounting for spatial overlap. Additionally, 130 radiomic features (RF) were extracted from HSV at W0, and their variations during CRT were quantified by relative deviations (∆RF). Prediction of treatment outcome was considered statistically relevant after being corrected for multiple testing and confirmed for the two 18F-FMISO-PET/CT time-points and for a validation cohort. HSV decreased in 64% of patients at W2 and in 80% at W5. CP distinguished earlier disease progression (geographically-dynamic) from later disease progression (geographically-static) in both time-points and cohorts. The texture feature low grey-level zone emphasis predicted local recurrence with AUCW2 = 0.82 and AUCW5 = 0.81 in initial cohort (N = 25) and AUCW2 = 0.79 and AUCW5 = 0.80 in validation cohort. Radiomics analysis of 18F-FMISO-derived hypoxia dynamics was able to predict outcome of HNSCC patients after CRT.</description><subject>Computed tomography</subject><subject>Head and neck carcinoma</subject><subject>Human papillomavirus</subject><subject>Hypoxia</subject><subject>Localization</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Open source software</subject><subject>Patients</subject><subject>Radiation therapy</subject><subject>Radiomics</subject><subject>Squamous cell carcinoma</subject><subject>Statistical analysis</subject><subject>Variation</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdUU1PGzEQtapWBQFnrpZ6drF3vF6bQyUUkQYJSMTH2fJ6vYnT7Dq1NxW58dMxIULQucyM3tN7M3oInTL6E0DRM2t662JiwDhwrr6gw4JWBRFC8a8f5gN0ktKS5gJglai-owPghZJCwCF6ZnJMxjdX91Myu3zAk-06PHmDb0LvhxB9P8dtiHjiTENM35BbZ__g0c4Xz8zgXT-kc3xnGh86bxO-6M1qm1zCs-gabwc8LByebgYbOodDi0cL1wWy42ckmvX2GH1rzSq5k30_Qo_jy4fRhFxPf1-NLq6JLTgoAmUlZevakiqoW17WlNZUslq5qspQQWvBmDAlZ8xKaErLKRSVFaIGKlhejtCvN931pu5cY_Pl0az0OvrOxK0OxuvPSO8Xeh7-aQkUlCqywI-9QAx_Ny4Nehk2Mf-bdFGWnGcXKTPr7I1lY0gpuvbdgVH9mpr-LzV4AewpiUs</recordid><startdate>20210709</startdate><enddate>20210709</enddate><creator>Carles, Montserrat</creator><creator>Fechter, Tobias</creator><creator>Grosu, Anca L.</creator><creator>Sörensen, Arnd</creator><creator>Thomann, Benedikt</creator><creator>Stoian, Raluca G.</creator><creator>Wiedenmann, Nicole</creator><creator>Rühle, Alexander</creator><creator>Zamboglou, Constantinos</creator><creator>Ruf, Juri</creator><creator>Martí-Bonmatí, Luis</creator><creator>Baltas, Dimos</creator><creator>Mix, Michael</creator><creator>Nicolay, Nils H.</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4220-9083</orcidid><orcidid>https://orcid.org/0000-0002-9106-2519</orcidid><orcidid>https://orcid.org/0000-0003-2022-897X</orcidid><orcidid>https://orcid.org/0000-0003-2550-1410</orcidid><orcidid>https://orcid.org/0000-0001-6271-9385</orcidid><orcidid>https://orcid.org/0000-0002-8234-010X</orcidid><orcidid>https://orcid.org/0000-0003-2401-8240</orcidid></search><sort><creationdate>20210709</creationdate><title>18F-FMISO-PET Hypoxia Monitoring for Head-and-Neck Cancer Patients: Radiomics Analyses Predict the Outcome of Chemo-Radiotherapy</title><author>Carles, Montserrat ; 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Our study aimed at evaluating radiomics dynamics of 18F-FMISO-hypoxia imaging during chemo-radiotherapy (CRT) as predictors for treatment outcome in head-and-neck squamous cell carcinoma (HNSCC) patients. We prospectively recruited 35 HNSCC patients undergoing definitive CRT and longitudinal 18F-FMISO-PET/CT scans at weeks 0, 2 and 5 (W0/W2/W5). Patients were classified based on peritherapeutic variations of the hypoxic sub-volume (HSV) size (increasing/stable/decreasing) and location (geographically-static/geographically-dynamic) by a new objective classification parameter (CP) accounting for spatial overlap. Additionally, 130 radiomic features (RF) were extracted from HSV at W0, and their variations during CRT were quantified by relative deviations (∆RF). Prediction of treatment outcome was considered statistically relevant after being corrected for multiple testing and confirmed for the two 18F-FMISO-PET/CT time-points and for a validation cohort. HSV decreased in 64% of patients at W2 and in 80% at W5. CP distinguished earlier disease progression (geographically-dynamic) from later disease progression (geographically-static) in both time-points and cohorts. The texture feature low grey-level zone emphasis predicted local recurrence with AUCW2 = 0.82 and AUCW5 = 0.81 in initial cohort (N = 25) and AUCW2 = 0.79 and AUCW5 = 0.80 in validation cohort. Radiomics analysis of 18F-FMISO-derived hypoxia dynamics was able to predict outcome of HNSCC patients after CRT.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34298663</pmid><doi>10.3390/cancers13143449</doi><orcidid>https://orcid.org/0000-0003-4220-9083</orcidid><orcidid>https://orcid.org/0000-0002-9106-2519</orcidid><orcidid>https://orcid.org/0000-0003-2022-897X</orcidid><orcidid>https://orcid.org/0000-0003-2550-1410</orcidid><orcidid>https://orcid.org/0000-0001-6271-9385</orcidid><orcidid>https://orcid.org/0000-0002-8234-010X</orcidid><orcidid>https://orcid.org/0000-0003-2401-8240</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Computed tomography Head and neck carcinoma Human papillomavirus Hypoxia Localization Metastases Metastasis Open source software Patients Radiation therapy Radiomics Squamous cell carcinoma Statistical analysis Variation |
| title | 18F-FMISO-PET Hypoxia Monitoring for Head-and-Neck Cancer Patients: Radiomics Analyses Predict the Outcome of Chemo-Radiotherapy |
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