Functional imaging early during (chemo)radiotherapy for response prediction in head and neck squamous cell carcinoma; a systematic review

•HNSCC showed prognostic changes in perfusion, diffusion and metabolic activity.•Intratreatment decrease of diffusion restriction (increase ADCmean) predicted LRC.•A low intratreatment SUVmax (low 18F-FDG uptake) were predictive of LRC.•A low SUVmax and total lesion glycolysis (TLG) predicted favora...

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Published in:Oral oncology 2019-01, Vol.88, p.75-83
Main Authors: Martens, Roland M., Noij, Daniel P., Ali, Meedie, Koopman, Thomas, Marcus, J. Tim, Vergeer, Marije R., de Vet, Henrica, de Jong, Marcus C., Leemans, C. René, Hoekstra, Otto S., de Bree, Remco, de Graaf, Pim, Boellaard, Ronald, Castelijns, Jonas A.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Chemoradiotherapy
Diffusion
Diffusion Magnetic Resonance Imaging
Female
Fluorodeoxyglucose F18 - metabolism
Glycolysis
Head and Neck
Head and Neck Neoplasms - chemistry
Head and Neck Neoplasms - diagnostic imaging
Head and Neck Neoplasms - metabolism
Head and Neck Neoplasms - therapy
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Local Recurrence
Neoplasm Recurrence, Local
Neoplasms
Perfusion MRI
Positron-Emission Tomography
Prognosis
Radiopharmaceuticals - metabolism
Squamous Cell Carcinoma of Head and Neck - chemistry
Squamous Cell Carcinoma of Head and Neck - diagnostic imaging
Squamous Cell Carcinoma of Head and Neck - metabolism
Squamous Cell Carcinoma of Head and Neck - therapy
Survival
Systematic review
Time Factors
Tomography, X-Ray Computed
Tomography, X-Ray Computed Perfusion
Treatment Outcome
Young Adult
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Summary:•HNSCC showed prognostic changes in perfusion, diffusion and metabolic activity.•Intratreatment decrease of diffusion restriction (increase ADCmean) predicted LRC.•A low intratreatment SUVmax (low 18F-FDG uptake) were predictive of LRC.•A low SUVmax and total lesion glycolysis (TLG) predicted favorable OS.•Best timing for imaging predicting LRC or OS is 2–3 weeks after start treatment. This systematic review gives an extensive overview of the current state of functional imaging during (chemo)radiotherapy to predict locoregional control (LRC) and overall survival (OS) for head and neck squamous cell carcinoma. MEDLINE and EMBASE were searched for literature until April 2018 assessing the predictive performance of functional imaging (computed tomography perfusion (CTp), MRI and positron-emission tomography (PET)) within 4 weeks after (chemo)radiotherapy initiation. Fifty-two studies (CTp: n = 4, MRI: n = 19, PET: n = 26, MRI/PET: n = 3) were included involving 1623 patients. Prognostic information was extracted according the PRISMA protocol. Pooled estimation and subgroup analyses were performed for comparable parameters and outcome. However, the heterogeneity of included studies limited the possibility for comparison. Early tumoral changes from (chemo)radiotherapy can be captured by functional MRI and 18F-FDG-PET and could allow for personalized treatment adaptation. Lesions showed potentially prognostic intratreatment changes in perfusion, diffusion and metabolic activity. Intratreatment ADCmean increase (decrease of diffusion restriction) and low SUVmax (persistent low or decrease of 18F-FDG uptake) were most predictive of LRC. Intratreatment persistent high or increase of perfusion on CT/MRI (i.e. blood flow, volume, permeability) also predicted LRC. Low SUVmax and total lesion glycolysis (TLG) predicted favorable OS. The optimal timing to perform functional imaging to predict LRC or OS was 2–3 weeks after treatment initiation.
ISSN:1368-8375
1879-0593
DOI:10.1016/j.oraloncology.2018.11.005