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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 12/2013

01-12-2013 | Original article

Potential of [18F]-Fluoromisonidazole positron-emission tomography for radiotherapy planning in head and neck squamous cell carcinomas

Authors: B. Henriques de Figueiredo, M.D., T. Merlin, H. de Clermont-Gallerande, M. Hatt, D. Vimont, P. Fernandez, F. Lamare

Published in: Strahlentherapie und Onkologie | Issue 12/2013

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Abstract

Background and purpose

Positron-emission tomography (PET) with [18F]-fluoromisonidazole (FMISO) permits consideration of radiotherapy dose escalation to hypoxic volumes in head and neck cancers (HNC). However, the definition of FMISO volumes remains problematic. The aims of this study are to confirm that delayed acquisition at 4 h is most appropriate for FMISO-PET imaging and to assess different methods of volume segmentation.

Patients and methods

A total of 15 HNC patients underwent several FMISO-PET/computed tomography (CT) acquisitions 2, 3 and 4 h after FMISO injection. Three automatic methods of PET image segmentation were tested: fixed threshold, adaptive threshold based on the ratio between tumour-derived and background activities (RT/B) and the fuzzy locally adaptive Bayesian (FLAB) method. The hypoxic fraction (HF), which is defined as the ratio between the FMISO and CT volumes, was also calculated.

Results

The RT/B for images acquired at 2, 3 and 4 h differed significantly, with mean values of 2.5 (1.7–2.9), 3 (2–4.5) and 3.4 (2.3–6.1), respectively. The mean tumour volume, as defined manually using CT images, was 39.1 ml (1.2–116 ml). After 4 h, the mean FMISO volumes were 18.9 (0.1–81), 9.5 (0.9–33.1) and 12.5 ml (0.9–38.4 ml) with fixed threshold, adaptive threshold and the FLAB method, respectively; median HF values were 0.47 (0.1–1.93), 0.25 (0.11–0.75) and 0.35 (0.14–1.05), respectively. FMISO volumes were significantly different.

Conclusion

The best contrast is obtained at the 4-hour acquisition time. Large discrepancies were found between the three tested methods of volume segmentation.
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Metadata
Title
Potential of [18F]-Fluoromisonidazole positron-emission tomography for radiotherapy planning in head and neck squamous cell carcinomas
Authors
B. Henriques de Figueiredo, M.D.
T. Merlin
H. de Clermont-Gallerande
M. Hatt
D. Vimont
P. Fernandez
F. Lamare
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 12/2013
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0454-7

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