Abstract
Tumor heterogeneity is furthered by mutation, selection and adaptation as the primary tumor spreads to regional or distant sites. While some similarities may be preserved among individual lesions there is multi-level biological variability between patients, within patients and within lesions. The concept of a more individualized treatment approach, known as precision medicine, is an emergent field and several immunohistochemical (IHC) biomarkers associated with hallmarks of cancer have been identified. Single tumor biopsies cannot detect intratumor heterogeneity for obvious reasons and molecular imaging would, in principle, offer the ideal solution by providing a non-invasive measurement of the biological properties of the entire extend of the tumor. In this study we perform a lesion level investigation of intratumor heterogeneity on cancer related biomarkers in head and neck tumors and investigate if global tumor measures on functional imaging can predict intratumor heterogeneity.
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