PET/MR study of Metastatic Lymph Nodes in Head and Neck Cancer

头颈癌转移性淋巴结的 PET/MR 研究

• 批准号: 8768574
• 负责人: Sungheon Gene Kim
• 金额: $ 35.17万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8768574
• 关键词: Aftercare; Blood Vessels; Carrier Proteins; Cell membrane; Cells; Contrast Media; Data; Detection; Diagnosis; Diagnostic Imaging; Dissection; Drug Kinetics; Evaluation; Excision; Gadolinium; Glucose Transporter; Goals; Head and Neck Cancer; Immunohistochemistry; Intracellular Space; Joints; Kinetics; Knowledge; Lymph Node Dissections; Lymphatic Metastasis; MRI Scans; Magnetic Resonance Imaging; Malignant Neoplasms; Measures; Methods; Modality; Modeling; Neoplasm Metastasis; Nodal; Non-Invasive Cancer Detection; Operative Surgical Procedures; Pathology; Patient Schedules; Patients; Phase; Phosphorylation; Physiological; Positron-Emission Tomography; Property; Reference Standards; Research; Residual Tumors; Role; Scanning; Schedule; Signal Transduction; Specificity; Staining method; Stains; Techniques; Testing; Therapy Evaluation; Tracer; United States; Validation; Vascular System; Visit; advanced disease; base; cancer type; fluorodeoxyglucose; fluorodeoxyglucose positron emission tomography; gadolinium oxide; glucose metabolism; glucose uptake; head and neck cancer patient; imaging modality; lymph nodes; neoplastic cell; public health relevance; response; treatment planning; tumor; tumor microenvironment

DESCRIPTION (provided by applicant): Head and neck cancers represent approximately 3% of invasive cancers (about 55,000 patients) diagnosed annually in the United States. Approximately two thirds of all patients present with locally advanced disease. The best chance for cure of head and neck cancer is typically aggressive treatment at initial presentation including complete lymph node dissection. Accurate identification of nodal metastases is a crucial step for treatment planning and evaluation of therapy response. Knowledge of the extent of nodal metastases prior to surgery can help avoid unnecessary removal of lymph nodes. However, current imaging methods are not adequate for reliable assessment of metastatic nodes in both diagnostic imaging and post-treatment evaluation. The overarching goal of this study is to develop PET/MR techniques for accurate, non-invasive detection of nodal metastases for treatment planning and assessment of residual tumor in metastatic nodes after treatment, such that unnecessary removal of nodes can be minimized. A state-of-the-art PET/MR scanner will be utilized to acquire PET and MRI data simultaneously within one session. Our central hypothesis is that a combined model of FDG-PET and DCE-MRI measures can detect metastatic nodes more accurately than FDG-PET or DCE-MRI alone. This hypothesis can be best tested when both PET and MRI scans are simultaneously conducted in one setting, as it can minimize any physiological difference in tumor microenvironment between separate PET and MRI scans, in addition to the benefit of fewer visits for the participating patients. We propose to conduct dynamic PET/MR scans with head and neck cancer patients (n=50) scheduled for full node dissection surgery so that pathological evaluation of dissected nodes can be used as the reference standard to evaluate the accuracy of PET/MR measures. During the surgery, the level of nodes will be recorded for level- to-level comparison between PET/MR and pathology evaluation. The first phase of the study (Aim 1) is to assess the extent of which a combination of FDG-PET and DCE- MRI measures can identify metastatic nodes more accurately than FDG-PET or DCE-MRI alone. Aim 2 is to determine the association between the kinetic parameters of FDG-PET and DCE-MRI and investigate the complimentary roles of FDG-PET and DCE-MRI parameters. Transport rate constant from the proposed joint analysis will be compared with the expression level of glucose transporters on the tumor cell membrane using immunohistochemistry staining. If successful, the research in this proposal will establish a more reliable and accurate method to non-invasively detect metastatic lymph nodes in head and neck cancer. This method can then also be extended to evaluating nodal metastasis for diagnosis and post-treatment evaluation in other types of cancer.

描述（由申请人提供）：头部和颈部癌症每年在美国诊断出约3％的侵入性癌症（约55,000名患者）。大约三分之二的患者患有局部晚期疾病。治愈头颈癌的最佳机会通常是在初始介绍（包括完整的淋巴结清除）时进行侵略性治疗。准确鉴定淋巴结转移是治疗计划和评估治疗反应的关键步骤。了解手术前淋巴结转移程度的知识可以帮助避免不必要地去除淋巴结。但是，当前的成像方法不足以在诊断成像和处理后评估中可靠评估转移性节点。这项研究的总体目标是开发PET/MR技术，以准确，无创的淋巴转移酶进行治疗计划和治疗后残留肿瘤评估的淋巴结转移，以便可以最大程度地减少节点的不必要的去除。最先进的宠物/先生扫描仪将在一次会议中同时获取PET和MRI数据。我们的中心假设是，与单独的FDG-PET或DCE-MRI相比，FDG-PET和DCE-MRI度量的组合模型可以更准确地检测转移性节点。当PET和MRI扫描同时在一种情况下进行时，可以最好地检验该假设，因为它可以最大程度地减少单独的PET和MRI扫描之间的肿瘤微环境的任何生理差异，此外还可以减少参与患者的访问较少的利益。我们建议使用计划进行全节点解剖手术的头颈癌患者（n = 50）进行动态PET/MR扫描，以便可以将解剖节点的病理评估用作评估PET/MR测量的准确性的参考标准。在手术期间，将记录节点水平，以进行PET/MR和病理评估之间的水平比较。该研究的第一阶段（AIM 1）是评估FDG-PET和DCE-MRI度量的组合比单独使用FDG-PET或DCE-MRI更准确地识别转移性节点的程度。目的2是确定FDG-PET和DCE-MRI的动力学参数之间的关联，并研究FDG-PET和DCE-MRI参数的免费作用。通过免疫组织化学染色将提出的关节分析的转运速率常数与肿瘤细胞膜上葡萄糖转运蛋白的表达水平进行比较。如果成功的话，该提案中的研究将建立一种更可靠，更准确的方法，以非侵入性检测头颈癌中的转移性淋巴结。然后，该方法还可以扩展到评估其他类型癌症的淋巴转移和治疗后评估。