Total lesion glycolysis of primary tumor and lymphnodes is a strong predictor for development of distant metastases in oropharyngeal carcinoma patients with independent validation in automatically delineated lesions.

IF 3.5 2区医学 Q2 ONCOLOGY

Cancer Imaging Pub Date : 2025-02-21 DOI:10.1186/s40644-025-00836-6

Sebastian Zschaeck, Marina Hajiyianni, Patrick Hausmann, Pavel Nikulin, Emily Kukuk, Christian Furth, Paulina Cegla, Elia Lombardo, Joanna Kazmierska, Adrien Holzgreve, Iosif Strouthos, Carmen Stromberger, Claus Belka, Michael Baumann, Mechthild Krause, Guillaume Landry, Witold Cholewinski, Jorg Kotzerke, Daniel Zips, Jörg van den Hoff, Frank Hofheinz

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引用次数: 0

Abstract

Background: Oropharyngeal carcinomas are characterized by an increasing incidence and a relatively good prognosis. Nonetheless, a considerable number of patients develops metachronous distant metastases; identification of these patients is an urgent medical need.

Methods: This is a retrospective multicenter evaluation of 431 patients. All patients underwent [¹⁸F]-FDG positron emission tomography (PET). The cohort was split into an explorative group (n = 366) and a validation group (n = 65). Lesions were manually delineated in the explorative group and automatically delineated by a convolutional neuronal network (CNN) in the validation group. Quantitative PET parameters standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated for primary tumors (_prim) and tumor plus lymphnodes (_all). Association of parameters with freedom from distant metastases (FFDM) and overall survival (OS) was tested by cox regression analyses.

Results: In the explorative group, univariate analyses revealed an association of metric MTV_prim (p = 0.022), MTV_all (p < 0.001) and TLG_all (p < 0.001) with FFDM, binarized parameters were also associated with FFDM (p < 0.001 and p = 0.002). Bootstrap analyses revealed a significantly better association of TLG_all compared to TLG_prim with FFDM (p = 0.02). MTV_all and TLG_all remained significantly associated with FFDM upon multivariate testing (p = 0.002, p = 0.031, respectively). In the validation group, the cutoff value for TLG_all but not for TLG_prim was significantly associated with FFDM (HR = 3.1, p = 0.045). Additional analyses with manually delineated contours of the validation cohort revealed a similar effect (HR = 3.47, p = 0.026). No considerable differences between HPV positive and negative disease were observed.

Conclusions: TLG_all is a promising biomarker to select OPC patients with high risk for metachronous distant metastases.

查看原文本刊更多论文

原发肿瘤和淋巴结的病灶糖酵解总量是口咽癌患者发生远处转移的一个强有力的预测指标，在自动划分的病变中具有独立的有效性。

背景：口咽癌的特点是发病率增加，预后相对较好。尽管如此，相当多的患者发生异时性远处转移；识别这些病人是一项迫切的医疗需要。方法：对431例患者进行回顾性多中心评估。所有患者均行[18F]-FDG正电子发射断层扫描（PET）。该队列分为探索组（n = 366）和验证组（n = 65）。在探索组中，病变是手动描绘的，在验证组中，病变是由卷积神经网络（CNN）自动描绘的。计算原发性肿瘤（prim）和肿瘤合并淋巴结（all）的定量PET参数标准化摄取值（SUV）、肿瘤代谢体积（MTV）和病灶总糖酵解（TLG）。通过cox回归分析检验参数与无远处转移（FFDM）和总生存期（OS）的关联。结果：在探索性组中，单变量分析显示度量MTVprim (p = 0.022), MTVall （p = 0.022）与TLGprim与FFDM之间存在关联（p = 0.02）。在多变量检验中，MTVall和TLGall仍与FFDM显著相关（p = 0.002, p = 0.031）。在验证组中，TLGall而非TLGprim的临界值与FFDM显著相关（HR = 3.1, p = 0.045）。对验证队列的人工轮廓线进行的其他分析显示了类似的效果（HR = 3.47, p = 0.026）。HPV阳性和阴性疾病之间没有明显差异。结论：TLGall是一种很有前景的生物标志物，可用于筛选异时性远处转移高风险的OPC患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Imaging ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

7.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Cancer Imaging is an open access, peer-reviewed journal publishing original articles, reviews and editorials written by expert international radiologists working in oncology. The journal encompasses CT, MR, PET, ultrasound, radionuclide and multimodal imaging in all kinds of malignant tumours, plus new developments, techniques and innovations. Topics of interest include: Breast Imaging Chest Complications of treatment Ear, Nose & Throat Gastrointestinal Hepatobiliary & Pancreatic Imaging biomarkers Interventional Lymphoma Measurement of tumour response Molecular functional imaging Musculoskeletal Neuro oncology Nuclear Medicine Paediatric.