TY - JOUR
T1 - Volumetric and texture analysis of pretherapeutic 18 F-FDG PET can predict overall survival in medullary thyroid cancer patients treated with Vandetanib
AU - Werner, Rudolf A.
AU - Bundschuh, Ralph A.
AU - Higuchi, Takahiro
AU - Javadi, Mehrbod S.
AU - Rowe, Steven P.
AU - Zsótér, Norbert
AU - Kroiss, Matthias
AU - Fassnacht, Martin
AU - Buck, Andreas K.
AU - Kreissl, Michael C.
AU - Lapa, Constantin
N1 - Publisher Copyright:
© 2018, The Author(s).
PY - 2019/2/15
Y1 - 2019/2/15
N2 - Purpose: The metabolically most active lesion in 2-deoxy-2-( 18 F)fluoro-D-glucose ( 18 F-FDG) PET/CT can predict progression-free survival (PFS) in patients with medullary thyroid carcinoma (MTC) starting treatment with the tyrosine kinase inhibitor (TKI) vandetanib. However, this metric failed in overall survival (OS) prediction. In the present proof of concept study, we aimed to explore the prognostic value of intratumoral textural features (TF) as well as volumetric parameters (total lesion glycolysis, TLG) derived by pre-therapeutic 18 F-FDG PET. Methods: Eighteen patients with progressive MTC underwent baseline 18 F-FDG PET/CT prior to and 3 months after vandetanib initiation. By manual segmentation of the tumor burden at baseline and follow-up PET, intratumoral TF and TLG were computed. The ability of TLG, imaging-based TF, and clinical parameters (including age, tumor marker doubling times, prior therapies and RET (rearranged during transfection) mutational status) for prediction of both PFS and OS were evaluated. Results: The TF Complexity and the volumetric parameter TLG obtained at baseline prior to TKI initiation successfully differentiated between low- and high-risk patients. Complexity allocated 10/18 patients to the high-risk group with an OS of 3.3 y (vs. low-risk group, OS = 5.3 y, 8/18, AUC = 0.78, P = 0.03). Baseline TLG designated 11/18 patients to the high-risk group (OS = 3.5 y vs. low-risk group, OS = 5 y, 7/18, AUC = 0.83, P = 0.005). The Hazard Ratio for cancer-related death was 6.1 for Complexity (TLG, 9.5). Among investigated clinical parameters, the age at initiation of TKI treatment reached significance for PFS prediction (P = 0.02, OS, n.s.). Conclusions: The TF Complexity and the volumetric parameter TLG are both independent parameters for OS prediction.
AB - Purpose: The metabolically most active lesion in 2-deoxy-2-( 18 F)fluoro-D-glucose ( 18 F-FDG) PET/CT can predict progression-free survival (PFS) in patients with medullary thyroid carcinoma (MTC) starting treatment with the tyrosine kinase inhibitor (TKI) vandetanib. However, this metric failed in overall survival (OS) prediction. In the present proof of concept study, we aimed to explore the prognostic value of intratumoral textural features (TF) as well as volumetric parameters (total lesion glycolysis, TLG) derived by pre-therapeutic 18 F-FDG PET. Methods: Eighteen patients with progressive MTC underwent baseline 18 F-FDG PET/CT prior to and 3 months after vandetanib initiation. By manual segmentation of the tumor burden at baseline and follow-up PET, intratumoral TF and TLG were computed. The ability of TLG, imaging-based TF, and clinical parameters (including age, tumor marker doubling times, prior therapies and RET (rearranged during transfection) mutational status) for prediction of both PFS and OS were evaluated. Results: The TF Complexity and the volumetric parameter TLG obtained at baseline prior to TKI initiation successfully differentiated between low- and high-risk patients. Complexity allocated 10/18 patients to the high-risk group with an OS of 3.3 y (vs. low-risk group, OS = 5.3 y, 8/18, AUC = 0.78, P = 0.03). Baseline TLG designated 11/18 patients to the high-risk group (OS = 3.5 y vs. low-risk group, OS = 5 y, 7/18, AUC = 0.83, P = 0.005). The Hazard Ratio for cancer-related death was 6.1 for Complexity (TLG, 9.5). Among investigated clinical parameters, the age at initiation of TKI treatment reached significance for PFS prediction (P = 0.02, OS, n.s.). Conclusions: The TF Complexity and the volumetric parameter TLG are both independent parameters for OS prediction.
KW - 2-deoxy-2-( F)fluoro-D-glucose
KW - F-FDG
KW - Medullary thyroid carcinoma
KW - Personalized medicine
KW - Positron emission tomography
KW - TKI
KW - Tyrosine kinase inhibitor
KW - Vandetanib
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U2 - 10.1007/s12020-018-1749-3
DO - 10.1007/s12020-018-1749-3
M3 - Article
C2 - 30206772
AN - SCOPUS:85053539490
SN - 1355-008X
VL - 63
SP - 293
EP - 300
JO - Endocrine
JF - Endocrine
IS - 2
ER -