Usefulness of 64Cu-ATSM in Head and Neck Cancer A Preliminary Prospective Study
Usefulness of 64Cu-ATSM in Head and Neck Cancer A Preliminary Prospective Study
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DOI：
10.1097/rlu.0b013e3182a756f0
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发表时间：
2014-01-01
影响因子：
10.6
通讯作者：
Fanti, Stefano
中科院分区：
文献类型：
--
作者：
Grassi, Ilaria;Nanni, Cristina;Fanti, Stefano
目的：Cu-64-二乙酰基-双（N4-甲基缩氨基硫脲）（Cu-64-ATSM）是一种耐缺氧的正电子放射性示踪剂。本研究的主要目的是评估治疗前Cu-64-ATSM PET/CT作为治疗反应的预后因素的有效性。次要目的是调查早期和晚期PET/CT扫描之间是否存在差异，放射治疗计划中Cu-64-ATSM和F-18-FDG之间计算的生物肿瘤体积（BTV）之间是否存在差异，并评估Cu-64-ATSM是否是疾病进展的预后标志物。治疗前后进行Cu-64-ATSM和F-18-FDG PET/CT扫描。结果：所有患者均为III期或IV期头颈部鳞癌，11例中7例有淋巴结转移，22个癌灶被Cu-64-ATSM检出。SUVmax为16.2 +/- 7.9，早期和晚期成像之间的SUVmax无显著差异。治疗前F-18-FDG SUVmax为15.6 ± 9.4，而治疗后F-18-FDG SUVmax为1.5 ± 1.2。根据受试者工作特征曲线计算的Cu-64-ATSM的灵敏度和特异性值分别为100%和50%（考虑SUVmax）和100%和33%（考虑体积）。结论：Cu-64-ATSM扫描在预测新辅助放化疗疗效方面敏感性高，特异性低。早期和晚期扫描之间没有差异。F-18-FDG和Cu-64-ATSM对BTV的显示结果相似。
Aims: Cu-64-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-64-ATSM) is a hypoxia-avid, positron emitter radiotracer. The primary aim of this study is to assess the efficacy of pretherapy Cu-64-ATSM PET/CT as a prognostic factor of response to therapy. The secondary aims are to investigate if there is a difference between early and late PET/CT scans and if there is a difference between the biologic tumor volume (BTV) in radiotherapy treatment planning calculated between Cu-64-ATSM and F-18-FDG, and to assess if Cu-64-ATSM is a prognostic marker of disease progression.Methods: Eleven patients with head and neck cancer treated with chemoradiotherapy were enrolled prospectively; both Cu-64-ATSM and F-18-FDG PET/CT scans before and after treatment were obtained. The Cu-64-ATSM scans were performed after 1 hour (early) and 16 hours (late).Results: All patients had stage III or IV squamous cell head and neck cancer; 7 of 11 patients had nodal metastasis, and 22 cancer foci were detected with Cu-64-ATSM. SUVmax was 16.2 +/- 7.9, and there was no significant SUVmax difference between early and late imaging. F-18-FDG SUVmax before therapy was 15.6 +/- 9.4, whereas F-18-FDG SUVmax after therapy was 1.5 +/- 1.2. Sensitivity and specificity values of Cu-64-ATSM calculated with receiver operating characteristic curves were 100% and 50% considering the SUVmax and 100% and 33% considering the volume, respectively. No difference has been found between the BTV contoured with Cu-64-ATSM and F-18-FDG.Conclusions: The Cu-64-ATSM scans showed high sensitivity but low specificity in predicting neoadjuvant chemoradiotherapy response. No difference was noted between early and late scans. F-18-FDG and Cu-64-ATSM provided similar results about delineation of BTV.