18F-FDG PET image biomarkers improve prediction of late radiation-induced xerostomia. Issue 1 (January 2018)

• Record Type: Journal Article
• Authors: van Dijk, Lisanne V.; Noordzij, Walter; Brouwer, Charlotte L.; Boellaard, Ronald; Burgerhof, Johannes G.M.; Langendijk, Johannes A.; Sijtsema, Nanna M.; Steenbakkers, Roel J.H.M.
• Is Part Of: Radiotherapy and oncology. Volume 126:Issue 1(2018)
• Page Start: 89
• Page End: 95
• Publication Date: 2018-01
• Subjects: Xerostomia -- NTCP -- Image biomarkers -- Head and neck cancer -- FDG-PET -- Radiomics; 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.2017.08.024
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Background and purpose: Current prediction of radiation-induced xerostomia 12 months after radiotherapy (Xer12m ) is based on mean parotid gland dose and baseline xerostomia (Xerbaseline ) scores. The hypothesis of this study was that prediction of Xer12m is improved with patient-specific characteristics extracted from 18 F-FDG PET images, quantified in PET image biomarkers (PET-IBMs). Patients and methods: Intensity and textural PET-IBMs of the parotid gland were collected from pre-treatment 18 F-FDG PET images of 161 head and neck cancer patients. Patient-rated toxicity was prospectively collected. Multivariable logistic regression models resulting from step-wise forward selection and Lasso regularisation were internally validated by bootstrapping. The reference model with parotid gland dose and Xerbaseline was compared with the resulting PET-IBM models. Results: High values of the intensity PET-IBM (90th percentile (P90)) and textural PET-IBM (Long Run High Grey-level Emphasis 3 (LRHG3E)) were significantly associated with lower risk of Xer12m . Both PET-IBMs significantly added in the prediction of Xer12m to the reference model. The AUC increased from 0.73 (0.65–0.81) (reference model) to 0.77 (0.70–0.84) (P90) and 0.77 (0.69–0.84) (LRHG3E). Conclusion: Prediction of Xer12m was significantly improved with pre-treatment PET-IBMs, indicating that high metabolic parotid gland activity is associated with lower risk of developing late xerostomia. This study highlights the potential of incorporating patient-specific PET-derived functional characteristics into NTCP model development.