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Title: Metabolic Imaging Biomarkers of Postradiotherapy Xerostomia

Abstract

Purpose: Xerostomia is a major complication of head and neck radiotherapy (RT). Available xerostomia measures remain flawed. [{sup 18}F]fluorodeoxyglucose-labeled positron emission tomography-computed tomography (FDG-PET-CT) is routinely used for staging and response assessment of head and neck cancer. We investigated quantitative measurement of parotid gland FDG uptake as a potential biomarker for post-RT xerostomia. Methods and Materials: Ninety-eight locally advanced head and neck cancer patients receiving definitive RT underwent baseline and post-RT FDG-PET-CT on a prospective imaging trial. A separate validation cohort of 14 patients underwent identical imaging while prospectively enrolled in a second trial collecting sialometry and patient-reported outcomes. Radiation dose and pre- and post-RT standard uptake values (SUVs) for all voxels contained within parotid gland ROI were deformably registered. Results: Average whole-gland or voxel-by-voxel models incorporating parotid D{sub Met} (defined as the pretreatment parotid SUV weighted by dose) accurately predicted posttreatment changes in parotid FDG uptake (e.g., fractional parotid SUV). Fractional loss of parotid FDG uptake closely paralleled early parotid toxicity defined by posttreatment salivary output (p < 0.01) and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer xerostomia scores (p < 0.01). Conclusions: In this pilot series, loss of parotid FDG uptake was strongly associatedmore » with acute clinical post-RT parotid toxicity. D{sub Met} may potentially be used to guide function-sparing treatment planning. Prospective validation of FDG-PET-CT as a convenient, quantifiable imaging biomarker of parotid function is warranted and ongoing.« less

Authors:
 [1];  [1]
  1. Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)
Publication Date:
OSTI Identifier:
22149420
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 83; Journal Issue: 5; 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; BIOLOGICAL MARKERS; FLUORINE 18; FLUORODEOXYGLUCOSE; GLANDS; HEAD; NECK; NEOPLASMS; PATIENTS; PLANNING; POSITRON COMPUTED TOMOGRAPHY; RADIATION DOSES; RADIOTHERAPY; STANDARDS; TOXICITY

Citation Formats

Cannon, Blake, Schwartz, David L., E-mail: dschwartz3@nshs.edu, Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, New York, Feinstein Institute for Medical Research, Manhasset, New York, and Lei, Dong. Metabolic Imaging Biomarkers of Postradiotherapy Xerostomia. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.10.074.
Cannon, Blake, Schwartz, David L., E-mail: dschwartz3@nshs.edu, Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, New York, Feinstein Institute for Medical Research, Manhasset, New York, & Lei, Dong. Metabolic Imaging Biomarkers of Postradiotherapy Xerostomia. United States. https://doi.org/10.1016/J.IJROBP.2011.10.074
Cannon, Blake, Schwartz, David L., E-mail: dschwartz3@nshs.edu, Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, New York, Feinstein Institute for Medical Research, Manhasset, New York, and Lei, Dong. 2012. "Metabolic Imaging Biomarkers of Postradiotherapy Xerostomia". United States. https://doi.org/10.1016/J.IJROBP.2011.10.074.
@article{osti_22149420,
title = {Metabolic Imaging Biomarkers of Postradiotherapy Xerostomia},
author = {Cannon, Blake and Schwartz, David L., E-mail: dschwartz3@nshs.edu and Department of Radiation Medicine, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, New York and Feinstein Institute for Medical Research, Manhasset, New York and Lei, Dong},
abstractNote = {Purpose: Xerostomia is a major complication of head and neck radiotherapy (RT). Available xerostomia measures remain flawed. [{sup 18}F]fluorodeoxyglucose-labeled positron emission tomography-computed tomography (FDG-PET-CT) is routinely used for staging and response assessment of head and neck cancer. We investigated quantitative measurement of parotid gland FDG uptake as a potential biomarker for post-RT xerostomia. Methods and Materials: Ninety-eight locally advanced head and neck cancer patients receiving definitive RT underwent baseline and post-RT FDG-PET-CT on a prospective imaging trial. A separate validation cohort of 14 patients underwent identical imaging while prospectively enrolled in a second trial collecting sialometry and patient-reported outcomes. Radiation dose and pre- and post-RT standard uptake values (SUVs) for all voxels contained within parotid gland ROI were deformably registered. Results: Average whole-gland or voxel-by-voxel models incorporating parotid D{sub Met} (defined as the pretreatment parotid SUV weighted by dose) accurately predicted posttreatment changes in parotid FDG uptake (e.g., fractional parotid SUV). Fractional loss of parotid FDG uptake closely paralleled early parotid toxicity defined by posttreatment salivary output (p < 0.01) and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer xerostomia scores (p < 0.01). Conclusions: In this pilot series, loss of parotid FDG uptake was strongly associated with acute clinical post-RT parotid toxicity. D{sub Met} may potentially be used to guide function-sparing treatment planning. Prospective validation of FDG-PET-CT as a convenient, quantifiable imaging biomarker of parotid function is warranted and ongoing.},
doi = {10.1016/J.IJROBP.2011.10.074},
url = {https://www.osti.gov/biblio/22149420}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 5,
volume = 83,
place = {United States},
year = {Wed Aug 01 00:00:00 EDT 2012},
month = {Wed Aug 01 00:00:00 EDT 2012}
}