TY - JOUR
T1 - Evaluation of tumour hypoxia during radiotherapy using [F-18]HX4 PET imaging and blood biomarkers in patients with head and neck cancer
AU - Zegers, Karen
AU - Hoebers, Frank J. P.
AU - van Elmpt, Wouter
AU - Bons, Judith A.
AU - Öllers, Michel
AU - Troost, Esther G. C.
AU - Eekers, Danielle
AU - Balmaekers, Leo
AU - Arts-Pechtold, Marlies
AU - Mottaghy, Felix M.
AU - Lambin, Philippe
PY - 2016/11
Y1 - 2016/11
N2 - Increased tumour hypoxia is associated with a worse overall survival in patients with head and neck squamous cell carcinoma (HNSCC). The aims of this study were to evaluate treatment-associated changes in [F-18]HX4-PET, hypoxia-related blood biomarkers, and their interdependence. [F-18]HX4-PET/CT scans of 20 patients with HNSCC were acquired at baseline and after +/- 20Gy of radiotherapy. Within the gross-tumour-volumes (GTV; primary and lymph nodes), mean and maximum standardized uptake values, the hypoxic fraction (HF) and volume (HV) were calculated. Also, the changes in spatial uptake pattern were evaluated using [F-18]HX4-PET/CT imaging. For all patients, the plasma concentration of CAIX, osteopontin and VEGF was assessed. At baseline, tumour hypoxia was detected in 69 % (22/32) of the GTVs. During therapy, we observed a significant decrease in all image parameters. The HF decreased from 21.7 +/- 19.8 % (baseline) to 3.6 +/- 10.0 % (during treatment; P <0.001). Only two patients had a HV > 1 cm(3) during treatment, which was located for > 98 % within the baseline HV. During treatment, no significant changes in plasma CAIX or VEGF were observed, while osteopontin was increased. [F-18]HX4-PET/CT imaging allows monitoring changes in hypoxia during (chemo)radiotherapy whereas the blood biomarkers were not able to detect a treatment-associated decrease in hypoxia.
AB - Increased tumour hypoxia is associated with a worse overall survival in patients with head and neck squamous cell carcinoma (HNSCC). The aims of this study were to evaluate treatment-associated changes in [F-18]HX4-PET, hypoxia-related blood biomarkers, and their interdependence. [F-18]HX4-PET/CT scans of 20 patients with HNSCC were acquired at baseline and after +/- 20Gy of radiotherapy. Within the gross-tumour-volumes (GTV; primary and lymph nodes), mean and maximum standardized uptake values, the hypoxic fraction (HF) and volume (HV) were calculated. Also, the changes in spatial uptake pattern were evaluated using [F-18]HX4-PET/CT imaging. For all patients, the plasma concentration of CAIX, osteopontin and VEGF was assessed. At baseline, tumour hypoxia was detected in 69 % (22/32) of the GTVs. During therapy, we observed a significant decrease in all image parameters. The HF decreased from 21.7 +/- 19.8 % (baseline) to 3.6 +/- 10.0 % (during treatment; P <0.001). Only two patients had a HV > 1 cm(3) during treatment, which was located for > 98 % within the baseline HV. During treatment, no significant changes in plasma CAIX or VEGF were observed, while osteopontin was increased. [F-18]HX4-PET/CT imaging allows monitoring changes in hypoxia during (chemo)radiotherapy whereas the blood biomarkers were not able to detect a treatment-associated decrease in hypoxia.
KW - Hypoxia
KW - PET
KW - CAIX
KW - Osteopontin
KW - VEGF
U2 - 10.1007/s00259-016-3429-y
DO - 10.1007/s00259-016-3429-y
M3 - Article
C2 - 27251643
SN - 1619-7070
VL - 43
SP - 2139
EP - 2146
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
IS - 12
ER -