Top

Published in:

Open Access 01-12-2021 | Positron Emission Tomography | Original research

Interim 4′-[methyl-¹¹C]-thiothymidine PET for predicting the chemoradiotherapeutic response in head and neck squamous cell carcinoma: comparison with [¹⁸F]FDG PET

Authors: Katsuya Mitamura, Takashi Norikane, Yuka Yamamoto, Kengo Fujimoto, Yasukage Takami, Hiroshi Hoshikawa, Jun Toyohara, Yoshihiro Nishiyama

Published in: EJNMMI Research | Issue 1/2021

Abstract

Purpose

We investigated the potential of interim 4′-[methyl-¹¹C]thiothymidine ([¹¹C]4DST) PET for predicting the chemoradiotherapeutic response for head and neck squamous cell carcinoma (HNSCC), in comparison with 2-deoxy-2-[¹⁸F]fluoro-D-glucose ([¹⁸F]FDG) PET.

Methods

A total of 32 patients with HNSCC who underwent both [¹¹C]4DST and [¹⁸F]FDG PET/CT before therapy (baseline) and at approximately 40 Gy point during chemoradiotherapy (interim) were available for a retrospective analysis of prospectively collected data. The baseline was treatment-naïve PET/CT scan as part of staging. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) from [¹⁸F]FDG PET or proliferative tumor volume (PTV) from [¹¹C]4DST PET, and total lesion glycolysis (TLG) from [¹⁸F]FDG PET or total lesion proliferation (TLP) from [¹¹C]4DST PET were measured. MTV or PTV was defined as the volume with an SUVmax greater than 2.5. The differences in SUVmax (ΔSUVmax), MTV (ΔMTV) or PTV (ΔPTV) and TLG (ΔTLG) or TLP (ΔTLP) from baseline to interim PET scans were calculated. Patients without or with evidence of residual or recurrent disease at 3 months after completion of chemoradiotherapy were classified as showing a complete response (CR) and non-CR, respectively.

Results

All patients showed increased uptake in primary tumor on baseline [¹¹C]4DST and [¹⁸F]FDG PET studies. All patients showed increased uptake on interim [¹⁸F]FDG PET, whereas 18 patients showed no increased uptake on interim [¹¹C]4DST PET. After chemoradiotherapy, 25 patients were found to be in CR group and 7 to be in non-CR group. [¹¹C]4DST ΔSUVmax, ΔPTV, and ΔTLP for CR group showed significantly greater reductions than the corresponding values for non-CR group (P = 0.044, < 0.001, < 0.001, respectively). However, there were no significant differences in [¹⁸F]FDG ΔSUVmax, ΔMTV, or ΔTLG between CR group and non-CR group. [¹¹C]4DST ΔMTV of -90 was the best cutoff value for the early identification of patients with non-CR.

Conclusion

These preliminary results suggest that interim [¹¹C]4DST PET might be useful for predicting the chemoradiotherapeutic response in patients with HNSCC, in comparison with [¹⁸F]FDG PET.

Bourhis J, Eschwege F. Radiotherapy-chemotherapy combinations in head and neck squamous cell carcinoma: overview of randomized trials. Anticancer Res. 1996;16:2397–402.PubMed

Bonomo P, Merlotti A, Olmetto E, Bianchi A, Desideri I, Bacigalupo A, et al. What is the prognostic impact of FDG PET in locally advanced head and neck squamous cell carcinoma treated with concomitant chemo-radiotherapy? A systematic review and meta-analysis. Eur J Nucl Med Mol Imaging. 2018;45:2122–38.CrossRef

Isles MG, McConkey C, Mehanna HM. A systematic review and meta-analysis of the role of positron emission tomography in the follow up of head and neck squamous cell carcinoma following radiotherapy or chemoradiotherapy. Clin Otolaryngol. 2008;33:210–22.CrossRef

Greven KM, Williams DW III, Frederick McGuirt Sr W, Harkness BA, D’Agostino RB Jr, Keyes JW Jr, et al. Serial positron emission tomography scans following radiation therapy of patients with head and neck cancer. Head Neck. 2001;23:942–6.CrossRef

Conessa C, Hervé S, Foehrenbach H, Poncet JL. FDG-PET scan in local follow-up of irradiated head and neck squamous cell carcinomas. Ann Otol Rhinol Laryngol. 2004;113:628–35.CrossRef

Toyohara J, Nariai T, Sakata M, Oda K, Ishii K, Kawabe T, et al. Whole-body distribution and brain tumor imaging with ¹¹C–4DST: a pilot study. J Nucl Med. 2011;52:1322–8.CrossRef

Minamimoto R, Takeda Y, Hotta M, Toyohara J, Nakajima K, Naka G, et al. ¹⁸F-FDG and ¹¹C–4DST PET/CT for evaluating response to platinum-based doublet chemotherapy in advanced non-small cell lung cancer: a prospective study. EJNMMI Res. 2019;9:4.CrossRef

Ito K, Yokoyama J, Miyata Y, Toyohara J, Okasaki M, Minamimoto R, et al. Volumetric comparison of positron emission tomography/computed tomography using 4’-[methyl-¹¹C]-thiothymidine with 2-deoxy-2-¹⁸F-fluoro-d-glucose in patients with advanced head and neck squamous cell carcinoma. Nucl Med Commun. 2015;36:219–25.CrossRef

Hoshikawa H, Mori T, Maeda Y, Takahashi S, Ouchi Y, Yamamoto Y, et al. Influence of volumetric 4’-[methyl-¹¹C]-thiothymidine PET/CT parameters for prediction of the clinical outcome of head and neck cancer patients. Ann Nucl Med. 2017;31:63–70.CrossRef

10.

Herrmann K, Krause BJ, Bundschuh RA, Dechow T, Schwaiger M. Monitoring response to therapeutic interventions in patients with cancer. Semin Nucl Med. 2009;39:210–32.CrossRef

11.

Pak K, Cheon GJ, Nam HY, Kim SJ, Kang KW, Chung JK, et al. Prognostic value of metabolic tumor volume and total lesion glycolysis in head and neck cancer: a systematic review and meta-analysis. J Nucl Med. 2014;55:884–90.CrossRef

12.

Ceulemans G, Voordeckers M, Farrag A, Verdries D, Storme G, Everaert H. Can 18-FDG-PET during radiotherapy replace post-therapy scanning for detection/demonstration of tumor response in head-and-neck cancer? Int J Radiat Oncol Biol Phys. 2011;81:938–42.CrossRef

13.

Kubota R, Yamada S, Kubota K, Ishiwata K, Tamahashi N, Ido T. Intratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo: high accumulation in macrophages and granulation tissues studied by microautoradiography. J Nucl Med. 1992;33:1972–80.PubMed

14.

Hentschel M, Appold S, Schreiber A, Abolmaali N, Abramyuk A, Dörr W, et al. Early FDG PET at 10 or 20 Gy under chemoradiotherapy is prognostic for locoregional control and overall survival in patients with head and neck cancer. Eur J Nucl Med Mol Imaging. 2011;38:1203–11.CrossRef

15.

Kishino T, Hoshikawa H, Nishiyama Y, Yamamoto Y, Mori N. Usefulness of 3’-deoxy-3’-¹⁸F-fluorothymidine PET for predicting early response to chemoradiotherapy in head and neck cancer. J Nucl Med. 2012;53:1521–7.CrossRef

16.

Menda Y, Boles Ponto LL, Dornfeld KJ, Tewson T, Watkins GL, Schulta M, et al. Kinetic analysis of 3′-deoxy-3′-¹⁸F-fluorothymidine (¹⁸F-FLT) in head and neck cancer patients before and early after initiation of chemoradiation therapy. J Nucl Med. 2009;50:1028–35.CrossRef

17.

Hoshikawa H, Mori T, Kishino T, Yamamoto Y, Inamoto R, Akiyama K, et al. Changes in ¹⁸F-fluorothymidine and ¹⁸F-fluorodeoxyglucose positron emission tomography imaging in patients with head and neck cancer treated with chemoradiotherapy. Ann Nucl Med. 2013;27:363–70.CrossRef

18.

Rogasch JM, Hofheinz F, Lougovski A, Furth C, Ruf J, Großer OS, et al. The influence of different signal-to-background ratios on spatial resolution and F18-FDG-PET quantification using point spread function and time-of-flight reconstruction. EJNMMI Phys. 2014;1:12.CrossRef

19.

Rasmussen JH, Fischer BM, Aznar MC, Hansen AE, Vogelius IR, Löfgren J, et al. Reproducibility of ¹⁸F-FDG PET uptake measurements in head and neck squamous cell carcinoma on both PET/CT and PET/MR. Br J Radiol. 2015;88:20140655.CrossRef

20.

Okamoto S, Shiga T, Yasuda K, Watanabe S, Hirata K, Nishijima KI, et al. The reoxygenation of hypoxia and the reduction of glucose metabolism in head and neck cancer by fractionated radiotherapy with intensity-modulated radiation therapy. Eur J Nucl Med Mol Imaging. 2016;43:2147–54.CrossRef

Title: Interim 4′-[methyl-11C]-thiothymidine PET for predicting the chemoradiotherapeutic response in head and neck squamous cell carcinoma: comparison with [18F]FDG PET
Authors: Katsuya Mitamura
Takashi Norikane
Yuka Yamamoto
Kengo Fujimoto
Yasukage Takami
Hiroshi Hoshikawa
Jun Toyohara
Yoshihiro Nishiyama
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keyword: Positron Emission Tomography
Published in: EJNMMI Research / Issue 1/2021
Electronic ISSN: 2191-219X
DOI: https://doi.org/10.1186/s13550-021-00749-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Interim 4′-[methyl-¹¹C]-thiothymidine PET for predicting the chemoradiotherapeutic response in head and neck squamous cell carcinoma: comparison with [¹⁸F]FDG PET

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

CERMEP-IDB-MRXFDG: a database of 37 normal adult human brain [18F]FDG PET, T1 and FLAIR MRI, and CT images available for research

Necrosis binding of Ac-Lys0(IRDye800CW)-Tyr3-octreotate: a consequence from cyanine-labeling of small molecules

Conscious rat PET imaging with soft immobilization for quantitation of brain functions: comprehensive assessment of anesthesia effects on cerebral blood flow and metabolism

Clinical implementation of PLANET® Dose for dosimetric assessment after [177Lu]Lu-DOTA-TATE: comparison with Dosimetry Toolkit® and OLINDA/EXM® V1.0

Visualizing cellularity and angiogenesis in newly-diagnosed glioblastoma with diffusion and perfusion MRI and FET-PET imaging

Convolutional neural network-based automatic heart segmentation and quantitation in 123I-metaiodobenzylguanidine SPECT imaging