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Title: Positron Emission Tomography/Computed Tomography Imaging of Residual Skull Base Chordoma Before Radiotherapy Using Fluoromisonidazole and Fluorodeoxyglucose: Potential Consequences for Dose Painting

Abstract

Purpose: To detect the presence of hypoxic tissue, which is known to increase the radioresistant phenotype, by its uptake of fluoromisonidazole (18F) (FMISO) using hybrid positron emission tomography/computed tomography (PET/CT) imaging, and to compare it with the glucose-avid tumor tissue imaged with fluorodeoxyglucose (18F) (FDG), in residual postsurgical skull base chordoma scheduled for radiotherapy. Patients and Methods: Seven patients with incompletely resected skull base chordomas were planned for high-dose radiotherapy (dose {>=}70 Gy). All 7 patients underwent FDG and FMISO PET/CT. Images were analyzed qualitatively by visual examination and semiquantitatively by computing the ratio of the maximal standardized uptake value (SUVmax) of the tumor and cerebellum (T/C R), with delineation of lesions on conventional imaging. Results: Of the eight lesion sites imaged with FDG PET/CT, only one was visible, whereas seven of nine lesions were visible on FMISO PET/CT. The median SUVmax in the tumor area was 2.8 g/mL (minimum 2.1; maximum 3.5) for FDG and 0.83 g/mL (minimum 0.3; maximum 1.2) for FMISO. The T/C R values ranged between 0.30 and 0.63 for FDG (median, 0.41) and between 0.75 and 2.20 for FMISO (median,1.59). FMISO T/C R >1 in six lesions suggested the presence of hypoxic tissue. There wasmore » no correlation between FMISO and FDG uptake in individual chordomas (r = 0.18, p = 0.7). Conclusion: FMISO PET/CT enables imaging of the hypoxic component in residual chordomas. In the future, it could help to better define boosted volumes for irradiation and to overcome the radioresistance of these lesions. No relationship was founded between hypoxia and glucose metabolism in these tumors after initial surgery.« less

Authors:
 [1];  [2]; ;  [3];  [4];  [5];  [6];  [7];  [8];  [9]; ; ;  [4]; ;  [10];  [3]
  1. Radiation Oncology Department, Antoine Lacassagne Center, Nice (France)
  2. (France)
  3. Department of Nuclear Medicine and Radiopharmacy, Tenon Hospital, and University Pierre et Marie Curie, Paris (France)
  4. Proton Therapy Center of Orsay, Curie Institute, Paris (France)
  5. Department of Neurosurgery, Pitie-Salpetriere Hospital, Paris (France)
  6. Department of Neurosurgery, Adolph De Rothschild Foundation, Paris (France)
  7. Department of Neurosurgery, Lariboisiere Hospital, Paris (France)
  8. Department of Pathology, Lariboisiere Hospital, Paris (France)
  9. Department of Pathology, Pitie-Salpetriere Hospital, Paris (France)
  10. CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice (France)
Publication Date:
OSTI Identifier:
22149568
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANOXIA; CAT SCANNING; CEREBELLUM; FLUORINE 18; FLUORODEOXYGLUCOSE; GLUCOSE; IRRADIATION; METABOLISM; NEOPLASMS; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; RADIATION DOSES; RADIOSENSITIVITY; RADIOTHERAPY; SKULL; SURGERY

Citation Formats

Mammar, Hamid, E-mail: hamid.mammar@unice.fr, CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice, Kerrou, Khaldoun, Nataf, Valerie, Pontvert, Dominique, Clemenceau, Stephane, Lot, Guillaume, George, Bernard, Polivka, Marc, Mokhtari, Karima, Ferrand, Regis, Feuvret, Loiec, Habrand, Jean-louis, Pouyssegur, Jacques, Mazure, Nathalie, and Talbot, Jean-Noeel. Positron Emission Tomography/Computed Tomography Imaging of Residual Skull Base Chordoma Before Radiotherapy Using Fluoromisonidazole and Fluorodeoxyglucose: Potential Consequences for Dose Painting. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.12.047.
Mammar, Hamid, E-mail: hamid.mammar@unice.fr, CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice, Kerrou, Khaldoun, Nataf, Valerie, Pontvert, Dominique, Clemenceau, Stephane, Lot, Guillaume, George, Bernard, Polivka, Marc, Mokhtari, Karima, Ferrand, Regis, Feuvret, Loiec, Habrand, Jean-louis, Pouyssegur, Jacques, Mazure, Nathalie, & Talbot, Jean-Noeel. Positron Emission Tomography/Computed Tomography Imaging of Residual Skull Base Chordoma Before Radiotherapy Using Fluoromisonidazole and Fluorodeoxyglucose: Potential Consequences for Dose Painting. United States. doi:10.1016/J.IJROBP.2011.12.047.
Mammar, Hamid, E-mail: hamid.mammar@unice.fr, CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice, Kerrou, Khaldoun, Nataf, Valerie, Pontvert, Dominique, Clemenceau, Stephane, Lot, Guillaume, George, Bernard, Polivka, Marc, Mokhtari, Karima, Ferrand, Regis, Feuvret, Loiec, Habrand, Jean-louis, Pouyssegur, Jacques, Mazure, Nathalie, and Talbot, Jean-Noeel. Thu . "Positron Emission Tomography/Computed Tomography Imaging of Residual Skull Base Chordoma Before Radiotherapy Using Fluoromisonidazole and Fluorodeoxyglucose: Potential Consequences for Dose Painting". United States. doi:10.1016/J.IJROBP.2011.12.047.
@article{osti_22149568,
title = {Positron Emission Tomography/Computed Tomography Imaging of Residual Skull Base Chordoma Before Radiotherapy Using Fluoromisonidazole and Fluorodeoxyglucose: Potential Consequences for Dose Painting},
author = {Mammar, Hamid, E-mail: hamid.mammar@unice.fr and CNRS-UMR 6543, Institute of Developmental Biology and Cancer, University of Nice Sophia Antipolis, Nice and Kerrou, Khaldoun and Nataf, Valerie and Pontvert, Dominique and Clemenceau, Stephane and Lot, Guillaume and George, Bernard and Polivka, Marc and Mokhtari, Karima and Ferrand, Regis and Feuvret, Loiec and Habrand, Jean-louis and Pouyssegur, Jacques and Mazure, Nathalie and Talbot, Jean-Noeel},
abstractNote = {Purpose: To detect the presence of hypoxic tissue, which is known to increase the radioresistant phenotype, by its uptake of fluoromisonidazole (18F) (FMISO) using hybrid positron emission tomography/computed tomography (PET/CT) imaging, and to compare it with the glucose-avid tumor tissue imaged with fluorodeoxyglucose (18F) (FDG), in residual postsurgical skull base chordoma scheduled for radiotherapy. Patients and Methods: Seven patients with incompletely resected skull base chordomas were planned for high-dose radiotherapy (dose {>=}70 Gy). All 7 patients underwent FDG and FMISO PET/CT. Images were analyzed qualitatively by visual examination and semiquantitatively by computing the ratio of the maximal standardized uptake value (SUVmax) of the tumor and cerebellum (T/C R), with delineation of lesions on conventional imaging. Results: Of the eight lesion sites imaged with FDG PET/CT, only one was visible, whereas seven of nine lesions were visible on FMISO PET/CT. The median SUVmax in the tumor area was 2.8 g/mL (minimum 2.1; maximum 3.5) for FDG and 0.83 g/mL (minimum 0.3; maximum 1.2) for FMISO. The T/C R values ranged between 0.30 and 0.63 for FDG (median, 0.41) and between 0.75 and 2.20 for FMISO (median,1.59). FMISO T/C R >1 in six lesions suggested the presence of hypoxic tissue. There was no correlation between FMISO and FDG uptake in individual chordomas (r = 0.18, p = 0.7). Conclusion: FMISO PET/CT enables imaging of the hypoxic component in residual chordomas. In the future, it could help to better define boosted volumes for irradiation and to overcome the radioresistance of these lesions. No relationship was founded between hypoxia and glucose metabolism in these tumors after initial surgery.},
doi = {10.1016/J.IJROBP.2011.12.047},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}