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: 8231807
• 负责人: Christopher Gerard Azzoli
• 金额: $ 63万
• 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/8231807
• 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; 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，我们研究了对接受新辅助化疗的 NSCLC 患者进行 18FM1S0 动态 PET (dynPET) 图像进行区室分析 (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%，而接受手术分期的 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结果的预后因素，这最终将导致新的治疗方案。肿瘤缺氧是包括非小细胞肺癌在内的多种癌症预后不良的独立预测因素。与其他癌症（例如 HNC）相比，成功进行缺氧成像对肺癌预后具有更大的相关性，因为 NSCLC 的局部控制相对较低。 18FM1S0 PET 已被证明与 NSCLC 中的缺氧相关，并且使用 18FMIS0 定量缺氧的最佳方法是通过相应 dynPET 图像的区室分析。然而，由于呼吸而导致的肺部 PET 图像中的 CA 是难以置信的。我们提出了一种对肺部 18FMIS0 dynPET 图像进行运动校正的新技术，使 CA 成为可能。我们 MSKCC 的团队是第一个建立呼吸门控和屏气 (BH) PET/CT 方法的团队。我们将使用常氧肺部背景下振荡低氧目标的蒙特卡罗模拟来量化由于目标运动而导致的 CA 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) 下以自由呼吸 (FB) 方式获取患者临床 18FMIS0 dynPET 图像。我们将使用患者的呼吸信号从 LM 数据中选择呼气末 (EE) 事件，以生成类似 BH 的 PET 数据集。动力学参数将从 FB 和 BH dynPET 图像的 CA 确定，然后进行比较以评估由于目标运动引起的差异。我们还将检查 NSCLC 患者中 18FMIS0 BH dynPET 进行 CA 的可行性，并将评估重复 18FMIS0 dynPET 中 CA 的重现性。最后，我们将研究 BH 18FMIS0 PET 是否会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，在未来的研究中，缺氧成像的结果将用于修改治疗。