Background
The use of imaging to implement on-treatment adaptation of radiotherapy is a promising paradigm but current data on imaging changes during radiotherapy is limited. This is a hypothesis-generating pilot study to examine the changes on multi-modality anatomic and functional imaging during (chemo)radiotherapy treatment for head and neck squamous cell carcinoma (HNSCC).
Abstract Introduction The aim of this study is to assess the geometric accuracy of diffusion weighted (DW)-MRI by quantification of geometric distortions in the gross tumor volume (GTV) in head and neck (HN) cancer. Materials & Methods A retrospective analysis was performed on the data of 23 patients (with 24 lesions). For these patients, magnetic field maps and DW-MRI were acquired. The magnetic field maps were converted to voxel displacement maps. GTV delineations were transferred onto these v...
Noninvasive imaging biomarkers readily assessed with PET/CT or MR imaging provide functional data that are absent from conventional anatomic imaging and that can be used to guide tailored treatment approaches in patients with squamous cell carcinomas of the head and neck.
Dynamic contrast-enhanced MRI (DCE-MRI) is a functional MRI method where T1 -weighted MR images are acquired dynamically after bolus injection of a contrast agent. The data can be interpreted in terms of physiological tissue characteristics by applying the principles of tracer-kinetic modelling. In the brain, DCE-MRI enables measurement of cerebral blood flow (CBF), cerebral blood volume (CBV), blood–brain barrier (BBB) permeability–surface area product (PS) and the volume of the interstitium (v...
This prospective study used sequential PET with the proliferation tracer 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) to monitor the early response to treatment of head and neck cancer and evaluated the association between PET parameters and clinical outcome. METHODS: Forty-eight patients with head and neck cancer underwent (18)F-FLT PET/CT before and during the second and fourth weeks of radiotherapy or chemoradiotherapy. Mean maximum standardized uptake values for the hottest voxel in the tum...
Abstract Defining the target for head and neck radiotherapy is a critical issue with the introduction of steep dose gradients associated with intensity-modulated radiotherapy. Tumour delineation inaccuracies are a major source of error in radiotherapy planning. The integration of 18-fluoride fluorodeoxyglucose positron emission tomography ( 18 FDG-PET) and magnetic resonance imaging directly into the radiotherapy planning process has the potential to greatly improve target identification/selecti...
Intensity-modulated radiotherapy (IMRT) is a newer method of radiotherapy that uses intensity-modulated beams that can provide multiple intensity levels for any single-beam direction and any single-source position, allowing concave dose distributions and dose gradients with narrower margins than those possible using conventional methods. IMRT is ideal for treating complex treatment volumes and avoiding close proximity organs at risk that may be dose limiting and provides increased tumour control...
#2Robert Jeraj(UW: University of Wisconsin-Madison)H-Index: 46
Last. Brian O'Sullivan(U of T: University of Toronto)H-Index: 110
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Intensity-modulated radiation therapy (IMRT) is a conformal irradiation technique that enables steep dose gradients. In head and neck tumours this approach spares parotid-gland function without compromise to treatment efficacy. Anatomical and molecular imaging modalities may be used to tailor treatment by enabling proper selection and delineation of target volumes and organs at risk, which in turn lead to dose prescriptions that take into account the underlying tumour biology (eg, human papillom...
#2Heiko Schöder(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 77
Last. Amita Shukla-Dave(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 33
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Purpose To correlate proton magnetic resonance spectroscopy ( 1 H-MRS), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and 18 F-labeled fluorodeoxyglucose positron emission tomography ([ 18 F]FDG PET) of nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) for assessment of tumor biology. Additionally, pretreatment multimodality imaging was evaluated for its efficacy in predicting short-term response to treatment. Methods and Materials Metastatic neck ...
#1Pierre Castadot(UCL: Université catholique de Louvain)H-Index: 7
#2Xavier Geets(UCL: Université catholique de Louvain)H-Index: 22
Last. Vincent Grégoire(UCL: Université catholique de Louvain)H-Index: 70
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BACKGROUND AND PURPOSE: The planning process in radiotherapy (RT) typically involves the acquisition of a unique set of CT images - and eventually of functional images - which is used for delineation of target volumes (TV) and organs at risk (OAR) and for dose calculation. Restricting the delineation and dose calculation solely on pre-treatment images is an oversimplification as it is only a snapshot of the patient's anatomy. The objectives of the present study were (1) to assess the consequence...
Purpose To analyze, in a pilot study, rapidly acquired dynamic contrast-enhanced (DCE)-MRI data with a general two-compartment exchange tracer kinetic model and correlate parameters obtained with measurements of hypoxia and vascular endothelial growth factor (VEGF) expression in patients with squamous cell carcinoma of the head and neck. Methods and Materials Eight patients were scanned before surgery. The DCE-MRI data were acquired with 1.5-s temporal resolution and analyzed using the two-compa...
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) accounts for 90% of head and neck cancers. There has been no established qualitative system of interpretation for therapy response assessment using PET-CT for HNSCC. AIM To assess response evaluation of nodal status in post-treatment PET-CT scans in HNSCC using a 5-point Likert scale (Deauville score [DS]). METHODS AND RESULTS Retro-prospective analysis was performed of the nodal status of pre and post-RT PET-CT in patients diagnosed with ...
PET-computed tomography (CT) plays a growing role to guide target volume delineation for head and neck cancer in radiation oncology. Pretherapeutic [18F]FDG PET-CT adds information to morphological imaging. First, as a whole-body imaging modality, it reveals regional or distant metastases that induce major therapeutic changes in more than 10% of the cases. Moreover, it allows better pathological lymph node selection which improves overall regional control and overall survival. Second, locally, i...
Based on the development of new hybrid machines consisting of an MRI and a linear accelerator, magnetic resonance image guided radiotherapy (MRgRT) has revolutionized the field of adaptive treatment in recent years. Although an increasing number of studies have been published, investigating technical and clinical aspects of this technique for various indications, utilizations of MRgRT for adaptive treatment of head and neck cancer (HNC) remains in its infancy. Yet, the possible benefits of this ...
Last. C. Rumley(UNSW: University of New South Wales)H-Index: 4
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Abstract It is increasingly recognised that head and neck cancer represents a spectrum of disease with a differential response to standard treatments. Although prognostic factors are well established, they do not reliably predict response. The ability to predict response early during radiotherapy would allow adaptation of treatment: intensifying treatment for those not responding adequately or de-intensifying remaining therapy for those likely to achieve a complete response. Functional imaging o...
Adaptive radiotherapy (ART) corresponds to various replanning strategies aiming to correct for anatomical variations occurring during the course of radiotherapy. The goal of the article was to report the rational, feasibility and benefit of using PET and/or MRI to guide this ART strategy in various tumor localizations. The anatomical modifications defined by scanner taking into account tumour mobility and volume variation are not always sufficient to optimise treatment. The contribution of funct...
Positron emission tomography/x-ray computed tomography (PET/CT) has long been discussed as a promising modality for response evaluation in cancer. When designing respective clinical trials, several design issues have to be addressed, especially the number/timing of PET/CT scans, the approach for quantifying metabolic activity, and the final translation of measurements into a rule. It is unclear how well these issues have been tackled in quest of an optimised use of PET/CT in response evaluation....
#1Houda Bahig(UdeM: Université de Montréal)H-Index: 5
#1Houda Bahig(UdeM: Université de Montréal)H-Index: 14
Last. Clifton D. Fuller(University of Texas MD Anderson Cancer Center)H-Index: 49
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Abstract Background Current standard radiotherapy for oropharynx cancer (OPC) is associated with high rates of severe toxicities, shown to adversely impact patients’ quality of life. Given excellent outcomes of human papilloma virus (HPV)-associated OPC and long-term survival of these typically young patients, treatment de-intensification aimed at improving survivorship while maintaining excellent disease control is now a central concern. The recent implementation of magnetic resonance image – g...
#2Arash Navran(NKI-AVL: Netherlands Cancer Institute)H-Index: 8
Last. Wouter V. Vogel(NKI-AVL: Netherlands Cancer Institute)H-Index: 30
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INTRODUCTION: In recent years, the possibility of adapting radiotherapy to changes in biological tissue parameters has emerged. It is hypothesized that early identification of radio-resistant parts of the tumor during treatment provides the possibility to adjust the radiotherapy plan to improve outcome. The aim of this systematic literature review was to evaluate the current state of the art of biological PET-guided adaptive radiotherapy, focusing on dose escalation to radio-resistant tumor. EVI...
#1Kee H. Wong(ICR: Institute of Cancer Research)H-Index: 10
#1KH Wong(ICR: Institute of Cancer Research)H-Index: 4
Last. Kate Newbold(ICR: Institute of Cancer Research)H-Index: 32
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Objective To assess the optimal timing and predictive value of early intra-treatment changes in multimodality functional and molecular imaging (FMI) parameters as biomarkers for clinical remission in patients receiving chemoradiation for head and neck squamous cell carcinoma (HNSCC).
#1Y.L. Dai(CUHK: The Chinese University of Hong Kong)H-Index: 1
#2Ann D. King(CUHK: The Chinese University of Hong Kong)H-Index: 61
Head and neck cancer affects more than 11,000 new patients per year in the UK1 and imaging has an important role in the diagnosis, treatment planning, and assessment, and post-treatment surveillance of these patients. The anatomical detail produced by magnetic resonance imaging (MRI) is ideally suited to staging and follow-up of primary tumours and cervical nodal metastases in the head and neck; however, anatomical images have limitations in cancer imaging and so increasingly functional-based MR...