Impact of hybrid PET/MR technology on multiparametric imaging and treatment response assessment of cervix cancer. Issue 3 (December 2017)

• Record Type: Journal Article
• Authors: Daniel, Michaela; Andrzejewski, Piotr; Sturdza, Alina; Majercakova, Katarina; Baltzer, Pascal; Pinker, Katja; Wadsak, Wolfgang; Mitterhauser, Markus; Pötter, Richard; Georg, Petra; Helbich, Thomas; Georg, Dietmar
• Is Part Of: Radiotherapy and oncology. Volume 125:Issue 3(2017:Dec.)
• Page Start: 420
• Page End: 425
• Publication Date: 2017-12
• Subjects: Hypoxia -- PET/MRI -- [18F]FMISO -- Treatment assessment -- Cervix cancer -- Multiparametric; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2017.10.036
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Background and purpose: Multimodal tissue characterization by combined MRI and PET has high clinical potential in the context of sub-target definition for dose painting and response assessment but its clinical exploration is yet limited. The aim of this study was to prove the potential and feasibility of hybrid PET/MRI to non-invasively measure tumor hypoxia, perfusion and microstructure at one stop in tumors of the uterine cervix during chemoradiotherapy. Material and methods: Ten cervix cancer patients were subjected to simultaneous multiparametric PET/MRI with [ 18 F]fluoromisonidazole ([ 18 F]FMISO). Imaging was scheduled before, twice during and after chemoradiotherapy. Intra- and inter-time point analyses of the extracted parameters (i.e. ADC, K trans, ABrix, [ 18 F]FMISO-tumor to background ratio (TBR)) were performed. The [ 18 F]FMISO uptake- and ADC-spatio-temporal changes were assessed. Results: Patient averaged ADC values increased from baseline to follow up (1.03 ± 0.11/1.30 ± 0.13 × 10 −3 mm 2 /s), while the TBR decreased (1.73 ± 0.24/1.36 ± 0.19), K trans dropped over time (0.17 ± 0.05/0.05 ± 0.05 min −1 ); for all above p < 0.05. None of these parameters correlated significantly on a voxel-by-voxel basis. Low-ADC regions spatially varied over time. There was pronounced reduction of the [ 18 F]FMISO-avid volumes during treatment. Conclusions: The suggested hybrid PET/MRI protocol to non-invasively investigate tumor hypoxia, perfusion and microstructure at one stop was feasible, revealing spatio-temporal response patterns that could be utilized for comprehensive sub-target definition for dose painting and response assessment.