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Radiation Oncology
Published in: Radiation Oncology 1/2018

Open Access 01-12-2018 | Research

Effect of radiochemotherapy on T2* MRI in HNSCC and its relation to FMISO PET derived hypoxia and FDG PET

Authors: Nicole Wiedenmann, Hatice Bunea, Hans C. Rischke, Andrei Bunea, Liette Majerus, Lars Bielak, Alexey Protopopov, Ute Ludwig, Martin Büchert, Christian Stoykow, Nils H. Nicolay, Wolfgang A. Weber, Michael Mix, Philipp T. Meyer, Jürgen Hennig, Michael Bock, Anca L. Grosu

Published in: Radiation Oncology | Issue 1/2018

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Abstract

Background

To assess the effect of radiochemotherapy (RCT) on proposed tumour hypoxia marker transverse relaxation time (T2*) and to analyse the relation between T2* and 18F-misonidazole PET/CT (FMISO-PET) and 18F-fluorodeoxyglucose PET/CT (FDG-PET).

Methods

Ten patients undergoing definitive RCT for squamous cell head-and-neck cancer (HNSCC) received repeat FMISO- and 3 Tesla T2*-weighted MRI at weeks 0, 2 and 5 during treatment and FDG-PET at baseline. Gross tumour volumes (GTV) of tumour (T), lymph nodes (LN) and hypoxic subvolumes (HSV, based on FMISO-PET) and complementary non-hypoxic subvolumes (nonHSV) were generated. Mean values for T2* and SUVmean FDG were determined.

Results

During RCT, marked reduction of tumour hypoxia on FMISO-PET was observed (T, LN), while mean T2* did not change significantly. At baseline, mean T2* values within HSV-T (15 ± 5 ms) were smaller compared to nonHSV-T (18 ± 3 ms; p = 0.051), whereas FDG SUVmean (12 ± 6) was significantly higher for HSV-T (12 ± 6) than for nonHSV-T (6 ± 3; p = 0.026) and higher for HSV-LN (10 ± 4) than for nonHSV-LN (5 ± 2; p ≤ 0.011). Correlation between FMISO PET and FDG PET was higher than between FMSIO PET and T2* (R2 for GTV-T (FMISO/FDG) = 0.81, R2 for GTV-T (FMISO/T2*) = 0.32).

Conclusions

Marked reduction of tumour hypoxia between week 0, 2 and 5 found on FMISO PET was not accompanied by a significant T2*change within GTVs over time. These results suggest a relation between tumour oxygenation status and T2* at baseline, but no simple correlation over time. Therefore, caution is warranted when using T2* as a substitute for FMISO-PET to monitor tumour hypoxia during RCT in HNSCC patients.

Trial registration

DRKS, DRKS00003830 . Registered 23.04.2012.
Appendix
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Metadata
Title
Effect of radiochemotherapy on T2* MRI in HNSCC and its relation to FMISO PET derived hypoxia and FDG PET
Authors
Nicole Wiedenmann
Hatice Bunea
Hans C. Rischke
Andrei Bunea
Liette Majerus
Lars Bielak
Alexey Protopopov
Ute Ludwig
Martin Büchert
Christian Stoykow
Nils H. Nicolay
Wolfgang A. Weber
Michael Mix
Philipp T. Meyer
Jürgen Hennig
Michael Bock
Anca L. Grosu
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2018
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-018-1103-1

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