Predictive and prognostic values of pretreatment functional imaging-based biomarkers in advanced-stage laryngeal cancer

Year 2018, Volume: 8 Issue: 1, 1 - 12, 31.05.2018

Görkem Eskiizmir , Gülgün Yılmaz Ovalı Feray Aras Beyhan Cengiz Özyurt Serdar Tarhan

Abstract

Objective: To determine the quantitative
values of apparent diffusion coefficient (ADC), standardized uptake
values (SUVmax, SUVmean), metabolic tumor volume (MTV), metabolic tumor
volume indexes (MTImax, and MTImean) using diffusion weighted-MRI
(DW-MRI) and positron emission tomography/computed tomography (PET/CT),
and analyze the predictive and prognostic values of these biomarkers in a
homogenous group of patients with advanced-stage laryngeal cancer.




Methods:
Patients with newly diagnosed advanced-stage laryngeal cancer who had
both DW-MRI and 18F-FDG PET/CT before treatment, and who had curative
cancer treatment (surgery ± adjuvant therapy or radio ± chemotherapy)
between 2011 and 2015 were included in this study. All patients were
followed up clinically and radiologically, if necessary every 3 months
for the first 2 years, every 4-6 months for year 3, and then annually
thereafter.




Results:
Thirty-eight patients were retrospectively analyzed. Our analysis
demonstrated statistically significant differences when the pretreatment
SUV and MTImean value were compared between patients with stages III
and IV. Standardized uptake value was also a predictive factor for
N-stage. Moreover, a statistically significant difference was determined
when patients with and without perinodal involvement (PNI) were
compared. Log rank analysis demonstrated that none of functional
imaging-based biomarkers had a prognostic role for oncological outcomes.





Conclusion: Our
results demonstrated that pretreatment SUV and MTImean values were
predictive factors for staging, N-stage and PNI. Indeed, functional
imaging-based biomarkers are promising, novel, non-invasive techniques
that may provide additional information about tumor characteristics,
treatment selection and prognosis in the near future.

Keywords

Predictive, prognostic, imaging-based biomarkers, laryngeal cancer

References

• 1. Rudolph E, Dyckhoff G, Becher H, Dietz A, Ramroth H. Effects of tumour stage, comorbidity and therapy on survival of laryngeal cancer patients: a systematic review and a meta-analysis. Eur Arch Otorhinolaryngol 2011;268:165–79. 2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016;66:7–30. 3. Steuer CE, El-Deiry M, Parks JR, Higgins KA, Saba NF. An update on larynx cancer. CA Cancer J Clin 2017;67:31–50. 4. Bussu F, Micciche F, Rigante M, et al. Oncologic outcomes in advanced laryngeal squamous cell carcinomas treated with differ- ent modalities in a single institution: a retrospective analysis of 65 cases. Head Neck 2012;34:573–9. 5. Salvador-Coloma C, Cohen E. Multidisciplinary care of laryngeal cancer. J Oncol Pract 2016;12:717–24. 6. Eskiizmir G, Bask›n Y, Yalç›n F, Ellidokuz H, Ferris RL. Risk fac- tors for radiation failure in early-stage glottic carcinoma: a system- atic review and meta-analysis. Oral Oncol 2016;62:90–100. 7. Eskiizmir G, Tanyeri Toker G, Celik O, Gunhan K, Tan A, Ellidokuz H. Predictive and prognostic factors for patients with locoregionally advanced laryngeal carcinoma treated with surgical multimodality protocol. Eur Arch Otorhinolaryngol 2017;274: 1701–11. 8. Abraham J. Imaging for head and neck cancer. Surg Oncol Clin N Am 2015;24:455–71. 9. Maroldi R, Ravanelli M, Farina D. Magnetic resonance for laryn- geal cancer. Curr Opin Otolaryngol Head Neck Surg 2014;22: 131–9. 10. Suenaga Y, Kitajima K, Kanda T, et al. [(18)F]-FDG PET/CT imaging for detection of nodal metastases in patients with squa- mous cell carcinoma of the pharynx and larynx: comparison with CT. Jpn J Radiol 2016;34:203–10. 11. Mehanna H, Wong HL, McConkey CC, et al.; PET-NECK Trial Management Group. PET-CT surveillance versus neck dissection in advanced head and neck cancer. N Engl J Med 2016;374:1444– 54. 12. Mehanna H, McConkey CC, Rahman JK, et al. PET-NECK: a multicentre randomised Phase III non-inferiority trial comparing a positron emission tomography-computerised tomography-guid- ed watch-and-wait policy with planned neck dissection in the man- agement of locally advanced (N2/N3) nodal metastases in patients with squamous cell head and neck cancer. Health Technol Assess 2017;21:1–122. 13. Cammaroto G, Quartuccio N, Sindoni A, Di Mauro F, Caobelli F; Young AIMN Working Group. The role of PET/CT in the man- agement of patients affected by head and neck tumors: a review of the literature. Eur Arch Otorhinolaryngol 2016;273:1961–73. 14. Shang DS, Ruan LX, Zhou SH, Bao YY, Cheng KJ, Wang QY. Differentiating laryngeal carcinomas from precursor lesions by dif- fusion-weighted magnetic resonance imaging at 3.0 T: a prelimi- nary study. PLoS One 2013;8:e68622. 15. Varoquaux A, Rager O, Lovblad KO, et al. Functional imaging of head and neck squamous cell carcinoma with diffusion-weighted MRI and FDG PET/CT: quantitative analysis of ADC and SUV. Eur J Nucl Med Mol Imaging 2013;40:842–52. 16. Zhang Y, Liu X, Zhang Y, et al. Prognostic value of the primary lesion apparent diffusion coefficient (ADC) in nasopharyngeal car- cinoma: a retrospective study of 541 cases. Sci Rep 2015;5:12242. 17. Guo W, Luo D, Chen X, et al. Dynamic contrast-enhanced mag- netic resonance imaging for pretreatment prediction of early chemo-radiotherapy response in larynx and hypopharynx carcino- ma. Oncotarget 2017;8:33836–43. 18. Hatakenaka M, Soeada H, Yabuuchi H, et al. Apparent diffusion coefficients of breast tumors: clinical application. Magn Reson Med Sci 2008;7:23–9. 19. Chen Z, Ma L, Lou X, Zhou Z. Diagnostic value of minimum apparent diffusion coefficient values in prediction of neuroepithe- lial tumor grading. J Magn Reson Imaging 2010;31:1331–8. 20. Wang J, Takashima S, Takayama F, et al. Head and neck lesions: characterization with diffusion-weighted echo-planar MR imag- ing. Radiology 2001;220:621–30. 21. Srinivasan A, Dvorak R, Perni K, Rohrer S, Mukherji SK. Differentiation of benign and malignant pathology in the head and neck using 3T apparent diffusion coefficient values: early experi- ence. AJNR Am J Neuroradiol 2008;29:40–4. 22. Sasaki M, Eida S, Sumi M, Nakamura T. Apparent diffusion coef- ficient mapping for sinonasal diseases: differentiation of benign and malignant lesions. AJNR Am J Neuroradiol 2011;32:1100–6. 23. Tshering Vogel DW, Zbaeren P, Geretschlaeger A, Vermathen P, De Keyzer F, Thoeny HC. Diffusion-weighted MR imaging including bi-exponential fitting for the detection of recurrent or residual tumour after (chemo)radiotherapy for laryngeal and hypopharyngeal cancers. Eur Radiol 2013;23:562–9. 24. King AD, Chow KK, Yu KH, et al. Head and neck squamous cell carcinoma: diagnostic performance of diffusion-weighted MR imaging for the prediction of treatment response. Radiology 2013;266:531–8. 25. Lee NK, Kim S, Kim TU, Kim DU, Seo HI, Jeon TY. Diffusion- weighted MRI for differentiation of benign from malignant lesions in the gallbladder. Clin Radiol 2014;69:e78–85. 26. fierifo¤lu ‹, Oz ‹‹, Damar M, Tokgöz Ö, Yazgan Ö, Erdem Z. Diffusion-weighted imaging in the head and neck region: useful- ness of apparent diffusion coefficient values for characterization of lesions. Diagn Interv Radiol 2015;21:208–14. 27. Son SH, Kang SM, Jeong SY, et al. Prognostic value of volumet- ric parameters measured by pretreatment 18F FDG PET/CT in patients with cutaneous malignant melanoma. Clin Nucl Med 2016;41:e266–73. 28. Liu J, Dong M, Sun X, Li W, Xing L, Yu J. Prognostic value of 18F-FDG PET/CT in surgical non-small cell lung cancer: a meta- analysis. PLoS One 2016;11:e0146195. 29. Li YJ, Dai YL, Cheng YS, Zhang WB, Tu CQ. Positron emission tomography (18)F-fluorodeoxyglucose uptake and prognosis in patients with bone and sof tissue sarcoma. Eur J Surg Oncol 2016; 42:1103–14. 30. Takahashi M, Soma T, Mukasa A, Koyama K, Arai T, Momose T. An automated voxel-based method for calculating the reference value for a brain tumour metabolic index using 18F-FDG-PET and 11C-methionine PET. Ann Nucl Med 2017;31:250–9. 31. Choi EK, Yoo IR, Kim SH, Park SY, O JH, Kang BJ. The value of pre- and post-neoadjuvant chemotherapy F-18 FDG PET/CT scans in breast cancer: comparison with MRI. Acta Radiol 2018;2017;59:41–9. 32. Hwang SH, Cho A, Yun M, Choi YD, Rha SY, Kang WJ. Prognostic value of pretreatment metabolic tumor volume and total lesion glycolysis using 18F-FDG PET/CT in patients with metastatic renal cell carcinoma treated with anti-vascular endothe- lial growth factor-targeted agents. Clin Nucl Med 2017;42:e235– e41. 33. Pleitz JL, Sinha P, Dressler EV, Aouad RK. Correlation of positron emission tomography/computed tomography scan with smoking, tumor size, stage and differentiation in head and neck cancer patients. World J Nucl Med 2017;16:51–5. 34. Nakachi S, Okada M, Morishima S, et al. Clinical usefulness of FDG-PET/CT for the evaluation of various types of adult T-cell leukemia. Hematology 2017;22:536–43. 35. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310:2191–4. 36. Dirix P, Vandecaveye V, De Keyzer F, Stroobants S, Hermans R, Nuyts S. Dose painting in radiotherapy for head and neck squa- mous cell carcinoma: value of repeated functional imaging with (18)F-FDG PET, (18)F-fluoromisonidazole PET, diffusion- weighted MRI, and dynamic contrast-enhanced MRI. J Nucl Med 2009;50:1020–7. 37. Nakajo M, Nakajo M, Kajiya Y, et al. FDG PET/CT and diffu- sion-weighted imaging of head and neck squamous cell carcinoma: comparison of prognostic significance between primary tumor standardized uptake value and apparent diffusion coefficient. Clin Nucl Med 2012;37:475–80. 38. Houweling AC, Wolf AL, Vogel WV, et al. FDG-PET and diffu- sion-weighted MRI in head-and-neck cancer patients: implications for dose painting. Radiother Oncol 2013;106:250–4. 39. Subesinghe M, Scarsbrook AF, Sourbron S, et al. Alterations in anatomic and functional imaging parameters with repeated FDG PET-CT and MRI during radiotherapy for head and neck cancer: a pilot study. BMC Cancer 2015;15:137. 40. Preda L, Conte G, Bonello L, et al. Combining standardized uptake value of FDG-PET and apparent diffusion coefficient of DW-MRI improves risk stratification in head and neck squamous cell carcino- ma. Eur Radiol 2016;26:4432–41. 41. Choi JW, Lee D, Hyun SH, Han M, Kim JH, Lee SJ. Intratumoral heterogeneity measured using FDG PET and MRI is associated with tumour-stroma ratio and clinical outcome in head and neck squamous cell carcinoma. Clin Radiol 2017;72:482– 9. 42. Surov A, Meyer HJ, Wienke A. Correlation between apparent dif- fusion coefficient (ADC) and cellularity is different in several tumors: a meta-analysis. Oncotarget 2017;8:59492–99. 43. Driessen JP, Caldas-Magalhaes J, Janssen LM, et al. Diffusion- weighted MR imaging in laryngeal and hypopharyngeal carcino- ma: association between apparent diffusion coefficient and histo- logic findings. Radiology 2014;272:456–63. 44. Li B, Bobinski M, Gandour-Edwards R, Farwell DG, Chen AM. Overstaging of cartilage invasion by multidetector CT scan for laryngeal cancer and its potential effect on the use of organ preser- vation with chemoradiation. Br J Radiol 2011;84:64–9. 45. Kinschuck AJ, Goodyear PW, Lancaster J, et al. Accuracy of mag- netic resonance imaging in diagnosing thyroid cartilage and thy- roid gland invasion by squamous cell carcinoma in laryngectomy patients. J Laryngol Otol 2012;126:302–6. 46. Taha MS, Hassan O, Amir M, Taha T, Riad MA. Diffusion- weighted MRI in diagnosing thyroid cartilage invasion in laryngeal carcinoma. Eur Arch Otorrhinolaryngol 2014;271:2511–6. 47. Kendi AT, Corey A, Magliocca KR, et al. Is there a role for PET/CT parameters to differentiate thyroid cartilage invasion from penetration? Eur J Radiol 2016;85:319–23. 48. Schwartz DL, Harris J, Yao M, et al. Metabolic tumor volume as a prognostic imaging-based biomarker for head-and-neck cancer: pilot results from Radiation Therapy Oncology Group protocol 0522. Int J Radiat Oncol Biol Phys 2015;91:721–9. 49. Abdel Razek AA, Soliman NY, Elkhamary S, Alsharaway MK, Tawfik A. Role of diffusion-weighted MR imaging in cervical lym- phadenopathy. Eur Radiol 2006;16:1468–77. 50. Holzapfel K, Duetsch S, Fauser C, Eiber M, Rummeny EJ, Gaa J. Value of diffusion-weighted MR imaging in the differentiation between benign and malignant cervical lymph nodes. Eur J Radiol 2009;72:381–7. 51. de Bondt RB, Hoeberigs MC, Nelemans PJ, et al. Diagnostic accuracy and additional value of diffusion-weighted imaging for discrimination of malignant cervical lymph nodes in head and neck squamous cell carcinoma. Neuroradiology 2009;51:183–92. 52. Vandecaveye V, De Keyzer F, Vander Poorten V, et al. Head and neck squamous cell carcinoma: value of diffusion-weighted MR imaging for nodal staging. Radiology 2009;251:134–46. 53. Sumi M, Sakihama N, Sumi T, et al. Discrimination of metastatic cervical lymph nodes with diffusion-weighted MR imaging in patients with head and neck cancer. AJNR Am J Neuroradiol 2003; 24:1627–34. 54. Zhang Y, Chen J, Shen J, Zhong J, Ye R, Liang B. Apparent diffu- sion coefficient values of necrotic and solid portion of lymph nodes: differential diagnostic value in cervical lymphadenopathy. Clin Radiol 2013;68:224–31. 55. Kwee TC, Takahara T, Luijten PR, Nievelstein RA. ADC meas- urements of lymph nodes: inter- and intra-observer reproducibili- ty study and an overview of the literature. Eur J Radiol 2010;75: 215–20. 56. Hatakenaka M, Shioyama Y, Nakamura K, et al. Apparent diffu- sion coefficient calculated with relatively high b-values correlates with local failure of head and neck squamous cell carcinoma treated with radiotherapy. Am J Neuroradiol 2011;32:1904– 10. 57. Park GC, Kim JS, Roh JL, Choi SH, Nam SY, Kim SY. Prognostic value of metabolic tumor volume measured by 18F-FDG PET/CT in advanced-stage squamous cell carcinoma of the larynx and hypopharynx. Ann Oncol 2013;24:208–14. 58. Kitajima K, Suenaga Y, Kanda T, et al. Prognostic value of FDG PET imaging in patients with laryngeal cancer. PLoS One 2014;9: e96999. 59. Joo YH, Yoo IeR, Cho KJ, et al. Utility of 18F-FDG PET/CT in supracricoid partial laryngectomy. Acta Otolaryngol 2013;133: 1207–12. 60. Pak K, Cheon GJ, Nam HY, et al. Prognostic value of metabolic tumor volume and total lesion glycolysis in head and neck cancer: a systematic review and meta-analysis. J Nucl Med 2014;55:884– 90. 61. Yabuki K, Shiono O, Komatsu M, et al. Predictive and prognostic value of metabolic tumor volume (MTV) in patients with laryngeal carcinoma treated by radiotherapy (RT)/concurrent chemoradio- therapy (CCRT). PLoS One 2015;10:e0117924. 62. Yabuki K, Sano D, Shiono O, et al. Surgery-based versus radia- tion-based treatment strategy for a high metabolic volume laryn- geal cancer. Laryngoscope 2017;127:862–7.