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Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers

SIMPLE SUMMARY: The definition of tumor hypoxia is important in oncology because this characteristic is linked to a poor prognosis but remains debated because there are no reference modalities. In this context, we compared PET hypoxia (FMISO) and MRI data before surgery to determine the hypoxic volu...

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Autores principales: Gouel, Pierrick, Callonnec, Françoise, Obongo-Anga, Franchel-Raïs, Bohn, Pierre, Lévêque, Emilie, Gensanne, David, Hapdey, Sébastien, Modzelewski, Romain, Vera, Pierre, Thureau, Sébastien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047588/
https://www.ncbi.nlm.nih.gov/pubmed/36980806
http://dx.doi.org/10.3390/cancers15061918
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author Gouel, Pierrick
Callonnec, Françoise
Obongo-Anga, Franchel-Raïs
Bohn, Pierre
Lévêque, Emilie
Gensanne, David
Hapdey, Sébastien
Modzelewski, Romain
Vera, Pierre
Thureau, Sébastien
author_facet Gouel, Pierrick
Callonnec, Françoise
Obongo-Anga, Franchel-Raïs
Bohn, Pierre
Lévêque, Emilie
Gensanne, David
Hapdey, Sébastien
Modzelewski, Romain
Vera, Pierre
Thureau, Sébastien
author_sort Gouel, Pierrick
collection PubMed
description SIMPLE SUMMARY: The definition of tumor hypoxia is important in oncology because this characteristic is linked to a poor prognosis but remains debated because there are no reference modalities. In this context, we compared PET hypoxia (FMISO) and MRI data before surgery to determine the hypoxic volume at which to increase the radiotherapy dose in head and neck cancers. To our knowledge, this is the first study showing the value of combining tumor volumes obtained via PET and MRI to define the hypoxic lesion subvolume. The quantitative MRI parameters ADC, T1 mapping, and T2 mapping showed differences between hypoxic and normoxic volumes. ABSTRACT: Intratumoral hypoxia is associated with a poor prognosis and poor response to treatment in head and neck cancers. Its identification would allow for increasing the radiation dose to hypoxic tumor subvolumes. 18F-FMISO PET imaging is the gold standard; however, quantitative multiparametric MRI could show the presence of intratumoral hypoxia. Thus, 16 patients were prospectively included and underwent 18F-FDG PET/CT, 18F-FMISO PET/CT, and multiparametric quantitative MRI (DCE, diffusion and relaxometry T1 and T2 techniques) in the same position before treatment. PET and MRI sub-volumes were segmented and classified as hypoxic or non-hypoxic volumes to compare quantitative MRI parameters between normoxic and hypoxic volumes. In total, 13 patients had hypoxic lesions. The Dice, Jaccard, and overlap fraction similarity indices were 0.43, 0.28, and 0.71, respectively, between the FDG PET and MRI-measured lesion volumes, showing that the FDG PET tumor volume is partially contained within the MRI tumor volume. The results showed significant differences in the parameters of SUV in FDG and FMISO PET between patients with and without measurable hypoxic lesions. The quantitative MRI parameters of ADC, T1 max mapping and T2 max mapping were different between hypoxic and normoxic subvolumes. Quantitative MRI, based on free water diffusion and T1 and T2 mapping, seems to be able to identify intra-tumoral hypoxic sub-volumes for additional radiotherapy doses.
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spelling pubmed-100475882023-03-29 Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers Gouel, Pierrick Callonnec, Françoise Obongo-Anga, Franchel-Raïs Bohn, Pierre Lévêque, Emilie Gensanne, David Hapdey, Sébastien Modzelewski, Romain Vera, Pierre Thureau, Sébastien Cancers (Basel) Article SIMPLE SUMMARY: The definition of tumor hypoxia is important in oncology because this characteristic is linked to a poor prognosis but remains debated because there are no reference modalities. In this context, we compared PET hypoxia (FMISO) and MRI data before surgery to determine the hypoxic volume at which to increase the radiotherapy dose in head and neck cancers. To our knowledge, this is the first study showing the value of combining tumor volumes obtained via PET and MRI to define the hypoxic lesion subvolume. The quantitative MRI parameters ADC, T1 mapping, and T2 mapping showed differences between hypoxic and normoxic volumes. ABSTRACT: Intratumoral hypoxia is associated with a poor prognosis and poor response to treatment in head and neck cancers. Its identification would allow for increasing the radiation dose to hypoxic tumor subvolumes. 18F-FMISO PET imaging is the gold standard; however, quantitative multiparametric MRI could show the presence of intratumoral hypoxia. Thus, 16 patients were prospectively included and underwent 18F-FDG PET/CT, 18F-FMISO PET/CT, and multiparametric quantitative MRI (DCE, diffusion and relaxometry T1 and T2 techniques) in the same position before treatment. PET and MRI sub-volumes were segmented and classified as hypoxic or non-hypoxic volumes to compare quantitative MRI parameters between normoxic and hypoxic volumes. In total, 13 patients had hypoxic lesions. The Dice, Jaccard, and overlap fraction similarity indices were 0.43, 0.28, and 0.71, respectively, between the FDG PET and MRI-measured lesion volumes, showing that the FDG PET tumor volume is partially contained within the MRI tumor volume. The results showed significant differences in the parameters of SUV in FDG and FMISO PET between patients with and without measurable hypoxic lesions. The quantitative MRI parameters of ADC, T1 max mapping and T2 max mapping were different between hypoxic and normoxic subvolumes. Quantitative MRI, based on free water diffusion and T1 and T2 mapping, seems to be able to identify intra-tumoral hypoxic sub-volumes for additional radiotherapy doses. MDPI 2023-03-22 /pmc/articles/PMC10047588/ /pubmed/36980806 http://dx.doi.org/10.3390/cancers15061918 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gouel, Pierrick
Callonnec, Françoise
Obongo-Anga, Franchel-Raïs
Bohn, Pierre
Lévêque, Emilie
Gensanne, David
Hapdey, Sébastien
Modzelewski, Romain
Vera, Pierre
Thureau, Sébastien
Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers
title Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers
title_full Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers
title_fullStr Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers
title_full_unstemmed Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers
title_short Quantitative MRI to Characterize Hypoxic Tumors in Comparison to FMISO PET/CT for Radiotherapy in Oropharynx Cancers
title_sort quantitative mri to characterize hypoxic tumors in comparison to fmiso pet/ct for radiotherapy in oropharynx cancers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047588/
https://www.ncbi.nlm.nih.gov/pubmed/36980806
http://dx.doi.org/10.3390/cancers15061918
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