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Use of Baseline (18)F-FDG PET/CT to Identify Initial Sub-Volumes Associated With Local Failure After Concomitant Chemoradiotherapy in Locally Advanced Cervical Cancer

Introduction: Locally advanced cervical cancer (CC) patients treated by chemoradiotherapy (CRT) have a significant local recurrence rate. The objective of this work was to assess the overlap between the initial high-uptake sub-volume (V1) on baseline (18)F-fluorodeoxyglucose (FDG) positron emission...

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Autores principales: Lucia, François, Miranda, Omar, Abgral, Ronan, Bourbonne, Vincent, Dissaux, Gurvan, Pradier, Olivier, Hatt, Mathieu, Schick, Ulrike
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221149/
https://www.ncbi.nlm.nih.gov/pubmed/32457839
http://dx.doi.org/10.3389/fonc.2020.00678
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author Lucia, François
Miranda, Omar
Abgral, Ronan
Bourbonne, Vincent
Dissaux, Gurvan
Pradier, Olivier
Hatt, Mathieu
Schick, Ulrike
author_facet Lucia, François
Miranda, Omar
Abgral, Ronan
Bourbonne, Vincent
Dissaux, Gurvan
Pradier, Olivier
Hatt, Mathieu
Schick, Ulrike
author_sort Lucia, François
collection PubMed
description Introduction: Locally advanced cervical cancer (CC) patients treated by chemoradiotherapy (CRT) have a significant local recurrence rate. The objective of this work was to assess the overlap between the initial high-uptake sub-volume (V1) on baseline (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scans and the metabolic relapse (V2) sites after CRT in locally advanced CC. Methods: PET/CT performed before treatment and at relapse in 21 patients diagnosed with LACC and treated with CRT were retrospectively analyzed. CT images at the time of recurrence were registered to baseline CT using the 3D Slicer TM Expert Automated Registration module. The corresponding PET images were then registered using the corresponding transform. The fuzzy locally adaptive Bayesian (FLAB) algorithm was implemented using 3 classes (one for the background and the other two for tumor) in PET1 to simultaneously define an overall tumor volume and the sub-volume V1. In PET2, FLAB was implemented using 2 classes (one for background, one for tumor), in order to define V2. Four indices were used to determine the overlap between V1 and V2 (Dice coefficients, overlap fraction, X = (V1nV2)/V1 and Y = (V1nV2)/V2). Results: The mean (±standard deviation) follow-up was 26 ± 11 months. The measured overlaps between V1 and V2 were moderate to good according to the four metrics, with 0.62–0.81 (0.72 ± 0.05), 0.72–1.00 (0.85 ± 0.10), 0.55–1.00 (0.73 ± 0.16) and 0.50–1.00 (0.76 ± 0.12) for Dice, overlap fraction, X and Y, respectively. Conclusion: In our study, the overlaps between the initial high-uptake sub-volume and the recurrent metabolic volume showed moderate to good concordance. These results now need to be confirmed in a larger cohort using a more standardized patient repositioning procedure for sequential PET/CT imaging, as there is potential for RT dose escalation exploiting the pre-treatment PET high-uptake sub-volume.
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spelling pubmed-72211492020-05-25 Use of Baseline (18)F-FDG PET/CT to Identify Initial Sub-Volumes Associated With Local Failure After Concomitant Chemoradiotherapy in Locally Advanced Cervical Cancer Lucia, François Miranda, Omar Abgral, Ronan Bourbonne, Vincent Dissaux, Gurvan Pradier, Olivier Hatt, Mathieu Schick, Ulrike Front Oncol Oncology Introduction: Locally advanced cervical cancer (CC) patients treated by chemoradiotherapy (CRT) have a significant local recurrence rate. The objective of this work was to assess the overlap between the initial high-uptake sub-volume (V1) on baseline (18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scans and the metabolic relapse (V2) sites after CRT in locally advanced CC. Methods: PET/CT performed before treatment and at relapse in 21 patients diagnosed with LACC and treated with CRT were retrospectively analyzed. CT images at the time of recurrence were registered to baseline CT using the 3D Slicer TM Expert Automated Registration module. The corresponding PET images were then registered using the corresponding transform. The fuzzy locally adaptive Bayesian (FLAB) algorithm was implemented using 3 classes (one for the background and the other two for tumor) in PET1 to simultaneously define an overall tumor volume and the sub-volume V1. In PET2, FLAB was implemented using 2 classes (one for background, one for tumor), in order to define V2. Four indices were used to determine the overlap between V1 and V2 (Dice coefficients, overlap fraction, X = (V1nV2)/V1 and Y = (V1nV2)/V2). Results: The mean (±standard deviation) follow-up was 26 ± 11 months. The measured overlaps between V1 and V2 were moderate to good according to the four metrics, with 0.62–0.81 (0.72 ± 0.05), 0.72–1.00 (0.85 ± 0.10), 0.55–1.00 (0.73 ± 0.16) and 0.50–1.00 (0.76 ± 0.12) for Dice, overlap fraction, X and Y, respectively. Conclusion: In our study, the overlaps between the initial high-uptake sub-volume and the recurrent metabolic volume showed moderate to good concordance. These results now need to be confirmed in a larger cohort using a more standardized patient repositioning procedure for sequential PET/CT imaging, as there is potential for RT dose escalation exploiting the pre-treatment PET high-uptake sub-volume. Frontiers Media S.A. 2020-05-07 /pmc/articles/PMC7221149/ /pubmed/32457839 http://dx.doi.org/10.3389/fonc.2020.00678 Text en Copyright © 2020 Lucia, Miranda, Abgral, Bourbonne, Dissaux, Pradier, Hatt and Schick. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Lucia, François
Miranda, Omar
Abgral, Ronan
Bourbonne, Vincent
Dissaux, Gurvan
Pradier, Olivier
Hatt, Mathieu
Schick, Ulrike
Use of Baseline (18)F-FDG PET/CT to Identify Initial Sub-Volumes Associated With Local Failure After Concomitant Chemoradiotherapy in Locally Advanced Cervical Cancer
title Use of Baseline (18)F-FDG PET/CT to Identify Initial Sub-Volumes Associated With Local Failure After Concomitant Chemoradiotherapy in Locally Advanced Cervical Cancer
title_full Use of Baseline (18)F-FDG PET/CT to Identify Initial Sub-Volumes Associated With Local Failure After Concomitant Chemoradiotherapy in Locally Advanced Cervical Cancer
title_fullStr Use of Baseline (18)F-FDG PET/CT to Identify Initial Sub-Volumes Associated With Local Failure After Concomitant Chemoradiotherapy in Locally Advanced Cervical Cancer
title_full_unstemmed Use of Baseline (18)F-FDG PET/CT to Identify Initial Sub-Volumes Associated With Local Failure After Concomitant Chemoradiotherapy in Locally Advanced Cervical Cancer
title_short Use of Baseline (18)F-FDG PET/CT to Identify Initial Sub-Volumes Associated With Local Failure After Concomitant Chemoradiotherapy in Locally Advanced Cervical Cancer
title_sort use of baseline (18)f-fdg pet/ct to identify initial sub-volumes associated with local failure after concomitant chemoradiotherapy in locally advanced cervical cancer
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7221149/
https://www.ncbi.nlm.nih.gov/pubmed/32457839
http://dx.doi.org/10.3389/fonc.2020.00678
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