Prognostic value of tumor hypoxia, as measured by 18F-FMISO Breath Hold PET/CT

通过 18F-FMISO 屏气 PET/CT 测量肿瘤缺氧的预后价值

• 批准号: 8463480
• 负责人: Jamie Erin Chaft
• 金额: $ 58.31万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-05-01 至 2015-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8463480
• 关键词: Affect; Blood; Blood Vessels; Breath Tests; Breathing; Characteristics; Clinical; Data; Data Set; Drug Kinetics; Event; Failure; Future; Genetic; Goals; Hypoxia; Image; Imaging Techniques; Instruction; Kinetics; Lead; Lesion; Lung; Malignant Neoplasms; Malignant neoplasm of lung; Measurement; Measures; Mediastinal Neoplasms; Memorial Sloan-Kettering Cancer Center; Methodology; Methods; Morphologic artifacts; Motion; Neoadjuvant Therapy; Non-Small-Cell Lung Carcinoma; Operative Surgical Procedures; Outcome; PET/CT scan; Patients; Perfusion; Phenotype; Plasma; Positron-Emission Tomography; Prognostic Factor; Radioresistance; Recurrence; Reproducibility; Scanning; Signal Transduction; Simulate; Staging; Techniques; Treatment Failure; Treatment Protocols; Treatment outcome; Tumor Tissue; Tumor Volume; Uncertainty; Work; base; cancer type; chemotherapy; expiration; falls; improved; insight; novel; outcome forecast; prognostic; respiratory; simulation; tumor

DESCRIPTION (provided by applicant): In this proposal, we investigate the feasibility of performing compartmental analysis (CA) of 18FM1S0 dynamic PET (dynPET) images in NSCLC patients undergoing neoadjuvant chemotherapy. The 5-yr survival of stage IA NSCLC patients treated with surgery alone is 73%, falling to 58% and 13% for stages IB and IIIA respectively for patients who are surgically staged. Thus, it is necessary to identify prognostic factors determining patient outcome, which will ultimately lead to new treatment regimens. Tumor hypoxia is an independent predictor of poor prognosis in several types of cancer, including NSCLC. Achieving successful hypoxia imaging for prognosis in lung cancer is of greater relevance than for other cancers (e.g. HNC) because the local control in NSCLC is comparatively low. 18FM1S0 PET has been shown to correlate with hypoxia in NSCLC, and that the optimum method to quantitate hypoxia using 18FMIS0 is via compartment analysis of the corresponding dynPET images. However, CA is implausible with PET images of lung due to breathing. We propose a novel technique for motion-correction of 18FMIS0 dynPET images of lung to make CA possible. Our group at MSKCC was the first to establish the methodology for both respiratory gated and Breath-Hold (BH) PET/CT. We will quantitate the uncertainties in CA due to target motion using Monte Carlo simulations of oscillating hypoxic targets in normoxic lung background. We will then demonstrate our method's feasibility in clinical settings. We shall acquire patient clinical 18FMIS0 dynPET images in Free- Breathing (FB) in list mode (LM). We will select end-expiration (EE) events from the LM data using the patient's respiratory signal to produce a BH-like PET data set. Kinetic parameters will be determined from CA of both FB and BH dynPET images and then compared to assess differences due to target motion. We will also examine the feasibility of CA of 18FMIS0 BH dynPET of NSCLC in patients, and will assess the reproducibility of CA in repeat 18FMIS0 dynPET. Finally, we will investigate whether BH 18FMIS0 PET results in an improved correlation with treatment outcome. If this is the case, this approach may set the stage for future studies in which hypoxia imaging findings will be used to modify treatment.

描述（由申请人提供）：在本提案中，我们研究了在接受新辅助化疗的NSCLC患者中对18fm1so动态PET （dynPET）图像进行室室分析（CA）的可行性。单独手术治疗的IA期NSCLC患者的5年生存率为73%，而手术分期的IB期和IIIA期患者的5年生存率分别降至58%和13%。因此，有必要确定决定患者预后的预后因素，这将最终导致新的治疗方案。肿瘤缺氧是包括非小细胞肺癌在内的几种癌症预后不良的独立预测因子。由于非小细胞肺癌的局部控制率相对较低，因此与其他癌症（如HNC）相比，肺癌获得成功的缺氧成像对预后具有更大的相关性。18fm1so0 PET已被证明与NSCLC的缺氧相关，使用18FMIS0定量缺氧的最佳方法是通过相应的dynPET图像的隔室分析。然而，CA与肺的PET图像是不可信的。我们提出了一种新的肺18FMIS0动态pet图像运动校正技术，使CA成为可能。我们在MSKCC的小组是第一个建立呼吸门控和屏气（BH） PET/CT的方法。我们将使用蒙特卡罗模拟在常氧肺背景下振荡低氧靶，量化靶运动在CA中的不确定性。然后，我们将证明我们的方法在临床环境中的可行性。我们将在列表模式（LM）的自由呼吸模式（FB）下获取患者临床18FMIS0 dynPET图像。我们将使用患者的呼吸信号从LM数据中选择终末（EE）事件，以产生类似bh的PET数据集。动力学参数将从FB和BH dynPET图像的CA中确定，然后进行比较，以评估目标运动造成的差异。我们还将研究18FMIS0 BH dynPET在NSCLC患者中CA的可行性，并将评估重复18FMIS0 dynPET中CA的可重复性。最后，我们将研究BH 18FMIS0 PET是否与治疗结果有改善的相关性。如果是这样的话，这种方法可能为未来的研究奠定基础，在未来的研究中，缺氧成像结果将被用来修改治疗方法。