Pilot study of combined FDG-PET and dynamic contrast-enhanced CT of locally advanced cervical carcinoma before and during concurrent chemoradiotherapy suggests association between changes in tumor blood volume and treatment response

Thomas I. Banks, Rie von Eyben, Dimitre Hristov, Elizabeth A. Kidd

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Modern PET/CT radiotherapy simulators offer FDG-PET and dynamic contrast-enhanced (DCE) CT imaging for combined volumetric assessment of tumor metabolism and perfusion. However, the clinical utility of such assessment has not been clearly defined. Thus, in a prospective longitudinal study of primary cervical tumors treated with concurrent chemoradiotherapy (CCRT) we evaluated: (1) whether PET and perfusion parameters correlate or provide complementary information; (2) what imaging changes occur during CCRT; and (3) whether any parameters are predictive of treatment response as assessed by PET/CT 3 months posttherapy. FDG-PET/CT and DCE-CT scans were performed on 21 patients prior to and during CCRT. Coregistered volumetric parametric maps of standardized uptake value (SUV) measures and perfusion parameters blood flow (BF), blood volume (BV), and permeability were generated. Summary statistics for these parameters and their changes were calculated within the metabolic tumor volume (MTV). Correlations between SUV and BF/BV/permeability on local and global bases were assessed with Pearson's coefficient r. MTV, maximum SUV, and mean SUV decreased significantly between the pre- and during-treatment time points, while mean BV and permeability increased significantly. Global correlations between mean BF/BV/permeability and mean SUV values (−.15 < r <.29) were at most moderate. An increase in mean tumor BV during treatment was significantly correlated with complete metabolic response on 3-month posttreatment PET/CT. Weak correlations of SUV and perfusion parameters suggest a complementary role of FDG-PET and DCE-CT for tumor characterization. The association between relative change in mean BV and outcome suggests a potential role for DCE-CT in early evaluation of cervical tumor response to chemoradiotherapy.

Original languageEnglish (US)
Pages (from-to)3642-3651
Number of pages10
JournalCancer Medicine
Volume7
Issue number8
DOIs
StatePublished - Aug 2018
Externally publishedYes

Keywords

  • blood flow
  • blood volume
  • cervical cancer
  • cervix cancer
  • DCE-CT
  • FDG-PET
  • perfusion
  • permeability
  • radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Fingerprint Dive into the research topics of 'Pilot study of combined FDG-PET and dynamic contrast-enhanced CT of locally advanced cervical carcinoma before and during concurrent chemoradiotherapy suggests association between changes in tumor blood volume and treatment response'. Together they form a unique fingerprint.

  • Cite this