Imaging of tumour hypoxia and metabolism in patients with head and neck squamous cell carcinoma. (21st October 2015)

• Record Type: Journal Article
• Authors: Zegers, Catharina M. L.; van Elmpt, Wouter; Hoebers, Frank J. P.; Troost, Esther G. C.; Öllers, Michel C.; Mottaghy, Felix M.; Lambin, Philippe
• Is Part Of: Acta oncologica. Volume 54:Number 9(2015)
• Page Start: 1378
• Page End: 1384
• Publication Date: 2015-10-21
• Subjects: Oncology -- Periodicals; Cancer -- Treatment -- Periodicals; 616.992
• DOI: 10.3109/0284186X.2015.1062913
• Languages: English
• ISSNs: 0284-186X

Abstract

ABSTRACT: Background. Tumour hypoxia and a high tumour metabolism increase radioresistance in patients with head and neck squamous cell carcinoma (HNSCC). The aim of this study was to evaluate the correlation between hypoxia ([ 18 F]HX4 PET) and glucose metabolism ([ 18 F]FDG PET) molecular imaging. Material and methods. [ 18 F]HX4 and [ 18 F]FDG PET/CT images of 20 HNSCC patients were acquired prior to (chemo)radiotherapy, in an immobilisation mask, with a median time interval of seven days (NCT01347281). Gross tumour volumes of the primary lesions (GTVprim ) and pathological lymph nodes (GTVln ) were included in the analysis. [ 18 F]FDG PET/CT images were rigidly registered to the [ 18 F]HX4 PET/CT images. The maximum and mean standardised uptake values (SUVmax, SUVmean ) within both GTVs were determined. In addition, the overlap was compared between the [ 18 F]HX4 high volume ([ 18 F]HX4 HV) with a tumour-to-muscle ratio > 1.4 and the [ 18 F]FDG high volume ([ 18 F]FDG HV) with an SUV > 50% of the SUVmax . We report the mean± standard deviation. Results. PET/CT scans including 20 GTVprim and 12 GTVln were analysed. There was a significant correlation between several [ 18 F]FDG and [ 18 F]HX4 parameters, the most pronounced being the correlation between [ 18 F]FDG HV and [ 18 F]HX4 HV (R = 0.93, p < 0.001). The fraction of the GTVprim with a high HX4 uptake (9 ± 10%) was on average smaller than the FDG high fraction (51 ± 26%; p < 0.001). In 65% (13/20) of the patients, the GTVprim was hypoxic. In four of these patients the [ 18 F]HX4 HV was located within the [ 18 F]FDG HV, whereas for the remaining nine GTVprim a partial mismatch was observed. In these nine tumours 25 ± 21% (range 5–64%) of the HX4 HV was located outside the FDG HV. Conclusions. There is a correlation between [ 18 F]HX4 and [ 18 F]FDG uptake parameters on a global tumour level. In the majority of lesions a partial mismatch between the [ 18 F]HX4 and [ 18 F]FDG high uptake volumes was observed, therefore [ 18 F]FDG PET imaging cannot be used as a surrogate for hypoxia. [ 18 F]HX4 PET provides complementary information to [ 18 F]FDG PET imaging.