Athanasios Kafkaletos, Ilias Sachpazidis, Michael Mix, Montserrat Carles, Raluca Stoian, Henning Schäfer, Michael Bock, Dimos Baltas, Anca L Grosu
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The tumor cell density within the GTV was calculated from FDG SUV and from ADC maps. For the estimation of ADC-based cell density, we used a published tumor cell volume fraction (v<sub>TC</sub>). Agreement between FDG- and ADC-derived cell density estimates was assessed. The best-fitting v<sub>TC</sub>* was computed to achieve equal mean ρ<sub>ADC</sub> and ρ<sub>FDG</sub> for each patient and was compared to the literature.</p><p><strong>Results: </strong>The SUV and ADC metrics showed up to moderate negative correlations, but none of them were statistically significant at p < 0.05. The correlation of SUV<sub>mean</sub> vs. ADC<sub>mean</sub> with Pearson's correlation coefficient r = -0.426 and p = 0.054 and SUV<sub>max</sub> vs. ADC<sub>min</sub> with r = -0.414 and p = 0.062 suggested a weak negative trend. The average and standard deviation of mean ρ<sub>FDG</sub> and ρ<sub>ADC</sub> across our cohort were (1.8 ± 0.6) × 10<sup>8</sup> cells/ml and (3.3 ± 0.2) × 10<sup>8</sup> cells/ml. The difference between the mean ρ<sub>FDG</sub> and ρ<sub>ADC</sub> was statistically significant (p < 0.001). To achieve equal mean ρ<sub>ADC</sub> and ρ<sub>FDG</sub> for each patient, the mean optimal v<sub>TC</sub>* with standard deviation was 0.29 ± 0.09. Although significantly lower than the published mean v<sub>TC</sub> (0.54), v<sub>TC</sub>* lies within the published range of v<sub>TC</sub> for HNSCCs (0.28 to 0.75).</p><p><strong>Conclusion: </strong>ADC and SUV metrics exhibited moderate but marginally insignificant correlation in this dataset. Although not directly interchangeable, the two methods provide comparable, clinically relevant cell density estimates, offering flexibility to use the most accessible modality for individualized treatment planning.</p><p><strong>Trial registration: </strong>Registered at German Clinical Trials Register on 20/08/2015 (DRKS00003830).</p>","PeriodicalId":49639,"journal":{"name":"Radiation Oncology","volume":"20 1","pages":"137"},"PeriodicalIF":3.3000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403412/pdf/","citationCount":"0","resultStr":"{\"title\":\"Surrogating tumour cell density in head and neck cancer: [<sup>18</sup>F]FDG PET- versus ADC (MRI)-based approaches.\",\"authors\":\"Athanasios Kafkaletos, Ilias Sachpazidis, Michael Mix, Montserrat Carles, Raluca Stoian, Henning Schäfer, Michael Bock, Dimos Baltas, Anca L Grosu\",\"doi\":\"10.1186/s13014-025-02716-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>In this study we examined the correlation between standardized uptake value (SUV) of [<sup>18</sup>F]fluorodeoxyglucose (FDG) and apparent diffusion coefficient (ADC) within the gross tumor volume (GTV) of patients with head and neck squamous cell carcinoma (HNSCC). In addition, we assessed the comparability of cell density (ρ) estimates obtained from FDG PET and MRI data.</p><p><strong>Methods: </strong>Twenty-one HNSCC patients from a prospective FMISO imaging trial underwent pre-treatment PET/CT and MRI. We assessed correlations between FDG SUV (mean, max) and ADC (mean, min) within the GTV using Pearson's correlation coefficient. The tumor cell density within the GTV was calculated from FDG SUV and from ADC maps. For the estimation of ADC-based cell density, we used a published tumor cell volume fraction (v<sub>TC</sub>). Agreement between FDG- and ADC-derived cell density estimates was assessed. The best-fitting v<sub>TC</sub>* was computed to achieve equal mean ρ<sub>ADC</sub> and ρ<sub>FDG</sub> for each patient and was compared to the literature.</p><p><strong>Results: </strong>The SUV and ADC metrics showed up to moderate negative correlations, but none of them were statistically significant at p < 0.05. The correlation of SUV<sub>mean</sub> vs. ADC<sub>mean</sub> with Pearson's correlation coefficient r = -0.426 and p = 0.054 and SUV<sub>max</sub> vs. ADC<sub>min</sub> with r = -0.414 and p = 0.062 suggested a weak negative trend. The average and standard deviation of mean ρ<sub>FDG</sub> and ρ<sub>ADC</sub> across our cohort were (1.8 ± 0.6) × 10<sup>8</sup> cells/ml and (3.3 ± 0.2) × 10<sup>8</sup> cells/ml. The difference between the mean ρ<sub>FDG</sub> and ρ<sub>ADC</sub> was statistically significant (p < 0.001). To achieve equal mean ρ<sub>ADC</sub> and ρ<sub>FDG</sub> for each patient, the mean optimal v<sub>TC</sub>* with standard deviation was 0.29 ± 0.09. Although significantly lower than the published mean v<sub>TC</sub> (0.54), v<sub>TC</sub>* lies within the published range of v<sub>TC</sub> for HNSCCs (0.28 to 0.75).</p><p><strong>Conclusion: </strong>ADC and SUV metrics exhibited moderate but marginally insignificant correlation in this dataset. Although not directly interchangeable, the two methods provide comparable, clinically relevant cell density estimates, offering flexibility to use the most accessible modality for individualized treatment planning.</p><p><strong>Trial registration: </strong>Registered at German Clinical Trials Register on 20/08/2015 (DRKS00003830).</p>\",\"PeriodicalId\":49639,\"journal\":{\"name\":\"Radiation Oncology\",\"volume\":\"20 1\",\"pages\":\"137\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403412/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiation Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13014-025-02716-6\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiation Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13014-025-02716-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
Surrogating tumour cell density in head and neck cancer: [18F]FDG PET- versus ADC (MRI)-based approaches.
Objective: In this study we examined the correlation between standardized uptake value (SUV) of [18F]fluorodeoxyglucose (FDG) and apparent diffusion coefficient (ADC) within the gross tumor volume (GTV) of patients with head and neck squamous cell carcinoma (HNSCC). In addition, we assessed the comparability of cell density (ρ) estimates obtained from FDG PET and MRI data.
Methods: Twenty-one HNSCC patients from a prospective FMISO imaging trial underwent pre-treatment PET/CT and MRI. We assessed correlations between FDG SUV (mean, max) and ADC (mean, min) within the GTV using Pearson's correlation coefficient. The tumor cell density within the GTV was calculated from FDG SUV and from ADC maps. For the estimation of ADC-based cell density, we used a published tumor cell volume fraction (vTC). Agreement between FDG- and ADC-derived cell density estimates was assessed. The best-fitting vTC* was computed to achieve equal mean ρADC and ρFDG for each patient and was compared to the literature.
Results: The SUV and ADC metrics showed up to moderate negative correlations, but none of them were statistically significant at p < 0.05. The correlation of SUVmean vs. ADCmean with Pearson's correlation coefficient r = -0.426 and p = 0.054 and SUVmax vs. ADCmin with r = -0.414 and p = 0.062 suggested a weak negative trend. The average and standard deviation of mean ρFDG and ρADC across our cohort were (1.8 ± 0.6) × 108 cells/ml and (3.3 ± 0.2) × 108 cells/ml. The difference between the mean ρFDG and ρADC was statistically significant (p < 0.001). To achieve equal mean ρADC and ρFDG for each patient, the mean optimal vTC* with standard deviation was 0.29 ± 0.09. Although significantly lower than the published mean vTC (0.54), vTC* lies within the published range of vTC for HNSCCs (0.28 to 0.75).
Conclusion: ADC and SUV metrics exhibited moderate but marginally insignificant correlation in this dataset. Although not directly interchangeable, the two methods provide comparable, clinically relevant cell density estimates, offering flexibility to use the most accessible modality for individualized treatment planning.
Trial registration: Registered at German Clinical Trials Register on 20/08/2015 (DRKS00003830).
Radiation OncologyONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
6.50
自引率
2.80%
发文量
181
审稿时长
3-6 weeks
期刊介绍：
Radiation Oncology encompasses all aspects of research that impacts on the treatment of cancer using radiation. It publishes findings in molecular and cellular radiation biology, radiation physics, radiation technology, and clinical oncology.
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