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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

基本信息

批准号：
8677793
负责人：
Jamie Erin Chaft
金额：
$ 48.63万
依托单位：
SLOAN-KETTERING INST CAN RESEARCH
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-05-01 至 2016-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8677793
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 Monte Carlo Method 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 non-invasive imaging novel outcome forecast prognostic respiratory simulation tumor

项目摘要

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（由申请方提供）：在本提案中，我们研究了在接受新辅助化疗的NSCLC患者中对18 FM 1 S 0动态PET（dynPET）图像进行房室分析（CA）的可行性。仅接受手术治疗的IA期NSCLC患者的5年生存率为73%，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。肿瘤缺氧是几种类型癌症（包括NSCLC）预后不良的独立预测因子。实现成功的低氧成像对肺癌预后的意义大于其他癌症（例如HNC），因为NSCLC的局部控制相对较低。18FM 1 S 0 PET已被证明与NSCLC中的缺氧相关，并且使用18FMIS 0定量缺氧的最佳方法是通过相应dynPET图像的房室分析。然而，由于呼吸，CA与肺部的PET图像是不可信的。我们提出了一种新的技术，运动校正的18FMIS 0 dynPET图像的肺，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的方法的。我们将量化CA中的不确定性，由于目标运动使用蒙特卡罗模拟振荡低氧目标在常氧肺背景。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）下的自由呼吸（FB）下采集患者临床18FMIS 0 dynPET图像。我们将使用患者的呼吸信号从LM数据中选择呼气末（EE）事件，以产生类似BH的PET数据集。将根据FB和BH dynPET图像的CA确定动力学参数，然后进行比较，以评估靶运动引起的差异。我们还将检查18FMIS 0 BH dynPET在NSCLC患者中CA的可行性，并将评估CA在重复18FMIS 0 dynPET中的重现性。最后，我们将研究BH 18FMIS 0 PET是否能改善与治疗结果的相关性。如果是这样的话，这种方法可能会为未来的研究奠定基础，其中缺氧成像结果将用于修改治疗。