Abstract
BackgroundIn oropharyngeal squamous cell carcinoma (OPSCC), human papillomavirus (HPV)/p16 status is important as a prognostic biomarker.PurposeWe evaluated the relationship between 4′-[methyl-11C]-thiothymidine (11C-4DST) and 18F-FDG PET texture indices and p16 status in patients with newly diagnosed OPSCC.MethodsWe retrospectively reviewed the collected data of 256 consecutive, previously untreated patients with primary head and neck tumors enrolled between November 2011 and October 2019. Complete data on both 11C-4DST and 18F-FDG PET/CT studies before therapy, patients with OPSCC, and p16 status were available for 34 patients. Six of them were excluded because they did not exhibit sufficient 11C-4DST and/or 18F-FDG tumor uptake to perform textural analysis. Finally, 28 patients with newly diagnosed OPSCC were investigated. The maximum standardized uptake value (SUVmax) and 6 texture indices (homogeneity, entropy, short-run emphasis, long-run emphasis, low gray-level zone emphasis, and high gray-level zone emphasis) were derived from PET images. The presence of p16 expression in tumor specimens was examined by immunohistochemistry and compared with the PET parameters.ResultsUsing 11C-4DST, the expression of p16 was associated with a higher homogeneity (P = 0.012), lower short-run emphasis (P = 0.005), higher long-run emphasis (P = 0.009), and lower high-gray-level-zone emphasis (P = 0.042) values. There was no significant difference between 18F-FDG PET parameters and p16 status.ConclusionTexture indices of the primary tumor on 11C-4DST PET, but not 18F-FDG PET, may be of value in predicting the condition’s p16 status in patients with newly diagnosed OPSCC.
Highlights
Identifying the imaging biomarkers of tumors is very important because this information can provide useful targets for treatment without the requirement for tissue sampling (Schillaci and Urbano 2017)
While 18F-FDG directly reflects the glucose metabolism, Toyohara et al developed 4′-[methyl-11C]-thiothymidine (11C-4DST) for cell proliferation imaging that is resistant to degradation by thymidine phosphorylase and is incorporated into DNA (Toyohara et al 2006, 2008, 2011). 11C-4DST Positron emission tomography (PET) was found by Hoshikawa et al to provide important prognostic value in patients with head and neck squamous cell carcinoma (HNSCC) (Hoshikawa et al 2017)
We evaluated the relationship between 11C-4DST and 18F-FDG PET texture indices and p16 status in patients with newly diagnosed oropharyngeal squamous cell carcinoma (OPSCC)
Summary
Identifying the imaging biomarkers of tumors is very important because this information can provide useful targets for treatment without the requirement for tissue sampling (Schillaci and Urbano 2017). Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) has been built up as a biologically distinct from HPV-negative OPSCC (Ang et al 2010). 11C-4DST PET was found by Hoshikawa et al to provide important prognostic value in patients with HNSCC (Hoshikawa et al 2017). Though, detected no significant relationship between 18F-FDG SUV parameters for primary tumor and HPV status in patients with OPSCC or oral cavity squamous cell carcinoma (Kendi et al 2015). In oropharyngeal squamous cell carcinoma (OPSCC), human papillomavirus (HPV)/p16 status is important as a prognostic biomarker. Purpose: We evaluated the relationship between 4′-[methyl-11C]-thiothymidine (11C4DST) and 18F-FDG PET texture indices and p16 status in patients with newly diagnosed OPSCC
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