Bingxin Gu1,2,3,4, Jianping Zhang1,2,3,4,5,6, Guang Ma1,2,3,4, Shaoli Song1,2,3,4, Liqun Shi5,6, Yingjian Zhang1,2,3,4, Zhongyi Yang7,8,9,10. 1. Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, No. 270, Dong'an Road, Shanghai, 200032, Xuhui District, China. 2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. 3. Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China. 4. Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China. 5. Key Laboratory of Nuclear Physics and Ion-beam Application (MOE), Fudan University, Shanghai, 200433, China. 6. Department of Nuclear Science and Technology, Fudan University, Shanghai, 200433, China. 7. Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, No. 270, Dong'an Road, Shanghai, 200032, Xuhui District, China. zhongyiyang21@163.com. 8. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. zhongyiyang21@163.com. 9. Center for Biomedical Imaging, Fudan University, Shanghai, 200032, China. zhongyiyang21@163.com. 10. Shanghai Engineering Research Center of Molecular Imaging Probes, Shanghai, 200032, China. zhongyiyang21@163.com.
Abstract
BACKGROUND: Intratumoral heterogeneity has an enormous effect on patient treatment and outcome. The purpose of the current study was to establish and validate a nomogram with intratumoral heterogeneity derived from 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for prognosis of 5-Year progression-free survival (PFS) of patients with nasopharyngeal carcinoma (NPC). METHODS: A total of 171 NPC patients who underwent pretreatment 18F-FDG PET/CT were retrospectively enrolled. Data was randomly divided into training cohort (n = 101) and validation cohort (n = 70). The clinicopathologic parameters and the following PET parameters were analyzed: maximum and mean standardized uptake value (SUVmax, SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneity index (HI, SUVmax/SUVmean) for primary tumor and maximal neck lymph node. Cox analyses were performed on PFS in the training cohort. A prognostic nomogram based on this model was developed and validated. RESULTS: For the primary tumor, MTV-2.5, TLG-2.5, MTV-70%, and TLG-70% were significantly correlated with PFS. For the maximal neck lymph node, short diameter and HI were significantly correlated with PFS. Among the clinicopathologic parameters, M stage was a significant prognostic factor for recurrence. In multivariate analysis, M stage (P = 0.006), TLG-T-70% (P = 0.002), and HI-N (P = 0.018) were independent predictors. Based on this prognostic model, a nomogram was generated. The C-index of this model was 0.74 (95% CI: 0.63-0.85). For the cross validation, the C-index for the model was 0.73 (95% CI: 0.62-0.83) with the validation cohort. Patients with a risk score of ≥111 had poorer survival outcomes than those with a risk score of 0-76 and 77-110. CONCLUSIONS: Intratumoral heterogeneity derived from 18F-FDG PET/CT could predict long-term outcome in patients with primary NPC. A combination of PET parameters and the TNM stage enables better stratification of patients into subgroups with different PFS rates.
BACKGROUND: Intratumoral heterogeneity has an enormous effect on patient treatment and outcome. The purpose of the current study was to establish and validate a nomogram with intratumoral heterogeneity derived from 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for prognosis of 5-Year progression-free survival (PFS) of patients with nasopharyngeal carcinoma (NPC). METHODS: A total of 171 NPCpatients who underwent pretreatment 18F-FDG PET/CT were retrospectively enrolled. Data was randomly divided into training cohort (n = 101) and validation cohort (n = 70). The clinicopathologic parameters and the following PET parameters were analyzed: maximum and mean standardized uptake value (SUVmax, SUVmean), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneity index (HI, SUVmax/SUVmean) for primary tumor and maximal neck lymph node. Cox analyses were performed on PFS in the training cohort. A prognostic nomogram based on this model was developed and validated. RESULTS: For the primary tumor, MTV-2.5, TLG-2.5, MTV-70%, and TLG-70% were significantly correlated with PFS. For the maximal neck lymph node, short diameter and HI were significantly correlated with PFS. Among the clinicopathologic parameters, M stage was a significant prognostic factor for recurrence. In multivariate analysis, M stage (P = 0.006), TLG-T-70% (P = 0.002), and HI-N (P = 0.018) were independent predictors. Based on this prognostic model, a nomogram was generated. The C-index of this model was 0.74 (95% CI: 0.63-0.85). For the cross validation, the C-index for the model was 0.73 (95% CI: 0.62-0.83) with the validation cohort. Patients with a risk score of ≥111 had poorer survival outcomes than those with a risk score of 0-76 and 77-110. CONCLUSIONS: Intratumoral heterogeneity derived from 18F-FDG PET/CT could predict long-term outcome in patients with primary NPC. A combination of PET parameters and the TNM stage enables better stratification of patients into subgroups with different PFS rates.
Authors: Ji-Jin Yao; Li Lin; Tian-Sheng Gao; Wang-Jian Zhang; Wayne R Lawrence; Jun Ma; Ying Sun Journal: Cancer Res Treat Date: 2020-12-07 Impact factor: 4.679
Authors: Sebastian Zschaeck; Yimin Li; Qin Lin; Marcus Beck; Holger Amthauer; Laura Bauersachs; Marina Hajiyianni; Julian Rogasch; Vincent H Ehrhardt; Goda Kalinauskaite; Julian Weingärtner; Vivian Hartmann; Jörg van den Hoff; Volker Budach; Carmen Stromberger; Frank Hofheinz Journal: PLoS One Date: 2020-07-30 Impact factor: 3.240