PET in Sarcoma - A Clinical Trial

描述(由申请人提供)：在这份提案中，我们将在之前使用正电子发射断层扫描(PET)的基础上，为肉瘤患者的治疗做出贡献。我们在肉瘤患者中的研究也为PET在其他类型癌症中的应用提供了一个模型。使用[F-18]氟脱氧葡萄糖(FDG)和PET/CT，我们将对患者进行前瞻性成像研究，以确定他们的肿瘤代谢，以确定治疗反应，以及这些测量预测结果的能力。这项工作将继续评估FDG PET衍生肿瘤措施评估和预测局部肿瘤复发、转移和死亡时间的能力，使用基于标准流行病学概念的严格统计方法。作为临床结果替代终点的成像数据将通过假设驱动的研究进行测试，以验证临床结果数据。第一个具体目标将解决软组织肉瘤患者对新辅助化疗的肿瘤反应的特征。这一图像衍生的反应测量将通过与患者结果的相关性来验证，以确定FDG PET/CT成像作为这类患者治疗效果的替代终点的能力。在第二个特定目标中，FDG PET成像将以类似的方式用于表征骨肉瘤和尤文斯肉瘤肿瘤家族(ESFT)(包括外周神经外胚层肿瘤)患者的儿科和年轻人人群的治疗反应。在前面的目标中，我们将评估FDG PET图像衍生的肿瘤反应测量对新辅助化疗后患者预后的预测能力。在第三个具体目标中，我们将继续我们之前的工作，使用我们的复杂肿瘤FDG摄取分布的统计图像分析方法来量化肿瘤FDG代谢的异质性。这些数据将被分析以了解它们预测肿瘤反应和患者总体生存的能力。这种新的图像分析算法将被应用于用统计方法生成对肿瘤表面的半定量和空间评估。这些研究的重点是利用FDG PET图像中的定量数据和高水平的空间敏感性来表征肿瘤的代谢，并继续开发图像分析方法，为肿瘤的生物侵袭性提供相关数据和见解。

DESCRIPTION (provided by applicant): In this proposal, we build on our previous work using Positron Emission Tomography (PET) to contribute to the management of sarcoma patients. Our proposed studies in sarcoma patients also serve as a model for PET applications in other types of cancer. Using [F-18] fluorodeoxyglucose (FDG) and PET/CT, we will perform prospective imaging studies on patients to determine their tumor metabolism for identification of treatment response, and the ability of these measures to predict outcome. This work will continue our evaluation of the ability of FDG PET derived tumor measures to assess and predict time to local tumor recurrence, metastasis and death using rigorous statistical methods based on standard epidemiology concepts. Imaging data as surrogate endpoints for clinical outcome will be tested with hypothesis driven studies for validation with clinical outcomes data. The first specific aim will address characterization of tumor response to neoadjuvant chemotherapy in patients with soft tissue sarcomas. This image derived response measure will be validated by correlation with patient outcome to determine the ability of FDG PET/CT imaging to be used as a surrogate endpoint for treatment effectiveness in this group of patients. In the second specific aim, FDG PET imaging will be used in a similar manner to characterize treatment response in the pediatric and young adult population of patients with osteosarcoma and Ewings Sarcoma Family of Tumors (ESFT) which includes peripheral neuroectodermal tumors. As in the previous aim, we will evaluate the ability of the FDG PET image derived measure of tumor response to predict patient outcome after neoadjuvant chemotherapy. In a third specific aim, we will continue our previous work in quantitating measures of tumor heterogeneity in FDG metabolism using our statistical image analysis methods for complex tumor FDG uptake distribution. These data will be analyzed for their ability to predict tumor response, and patient overall survival. This new image analysis algorithm will be applied to generate a semi- quantitative and spatial assessment of the tumor surface with statistical methods. The focus of these studies are to exploit the quantitative data and high level of spatial sensitivity in FDG PET images to characterize tumor metabolism and to continue to develop image analysis methods that provide relevant data and insights on tumor biologic aggressiveness.