Effectiveness of Head-and-Neck Molecular Imaging Reporting and Data System Criterion in Head-and-Neck Squamous Cell Carcinoma PostConcurrent Chemoradiotherapy
Purpose: Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations wer...
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| Published in | Indian journal of nuclear medicine Vol. 38; no. 4; pp. 334 - 339 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
India
Wolters Kluwer - Medknow
01.10.2023
Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd |
| Edition | 2 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0972-3919 0974-0244 |
| DOI | 10.4103/ijnm.ijnm_23_23 |
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| Abstract | Purpose:
Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations were needed. We tested the effectiveness of a proposed semi-quantitative molecular response criterion in these patients.
Materials and Methods:
Two subspecialty-trained physicians evaluated 18F-fluorodeoxyglucose positron emission tomography/computed tomography of LA-HNSCC patients (n = 83) post 3 months CRT using a five points Head and Neck Molecular Imaging-Reporting and Data System (HAN-MI-RADS) criterion. Where available, histopathology examination with clinical and imaging interpretation was taken as a reference for the disease. A diagnostic accuracy comparison was done with the existing Hopkins score. Further effectiveness was analyzed with disease-free survival (DFI) and overall survival (OS).
Results:
Metastasis was developed in 11/83 patients at 3 months of evaluation. Of 72 patients, 39, 2, and 31 patients had a complete response, equivocal response, and partial response as per HAN-MI-RADS. Per patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting loco-regional disease up to 1 and 2 years was 93.3%, 92.5%, 90.3%, 94.9%, 92.9%, and 84.9%, 91.9%, 90.3%, 87.2%, and 88.6% respectively. One year and two years DFI for each HAN-MI-RADS score showed a statistically significant difference while it was not for OS. The receiver operating characteristic curve analysis showed significantly better outcome predictability of HAN-MI-RADS (area under the curve [AUC] 0.884) than Hopkins (AUC 0.699).
Conclusions:
A five points HAN-MI-RADS criterion was found promising for response assessment with less equivocal results and statistically significant higher AUC than Hopkins for loco-regional recurrence prediction. |
|---|---|
| AbstractList | Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations were needed. We tested the effectiveness of a proposed semi-quantitative molecular response criterion in these patients.
Two subspecialty-trained physicians evaluated
F-fluorodeoxyglucose positron emission tomography/computed tomography of LA-HNSCC patients (
= 83) post 3 months CRT using a five points Head and Neck Molecular Imaging-Reporting and Data System (HAN-MI-RADS) criterion. Where available, histopathology examination with clinical and imaging interpretation was taken as a reference for the disease. A diagnostic accuracy comparison was done with the existing Hopkins score. Further effectiveness was analyzed with disease-free survival (DFI) and overall survival (OS).
Metastasis was developed in 11/83 patients at 3 months of evaluation. Of 72 patients, 39, 2, and 31 patients had a complete response, equivocal response, and partial response as per HAN-MI-RADS. Per patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting loco-regional disease up to 1 and 2 years was 93.3%, 92.5%, 90.3%, 94.9%, 92.9%, and 84.9%, 91.9%, 90.3%, 87.2%, and 88.6% respectively. One year and two years DFI for each HAN-MI-RADS score showed a statistically significant difference while it was not for OS. The receiver operating characteristic curve analysis showed significantly better outcome predictability of HAN-MI-RADS (area under the curve [AUC] 0.884) than Hopkins (AUC 0.699).
A five points HAN-MI-RADS criterion was found promising for response assessment with less equivocal results and statistically significant higher AUC than Hopkins for loco-regional recurrence prediction. Purpose: Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations were needed. We tested the effectiveness of a proposed semi-quantitative molecular response criterion in these patients. Materials and Methods: Two subspecialty-trained physicians evaluated [sup.18]F-fluorodeoxyglucose positron emission tomography/computed tomography of LA-HNSCC patients (n = 83) post 3 months CRT using a five points Head and Neck Molecular Imaging-Reporting and Data System (HAN-MI-RADS) criterion. Where available, histopathology examination with clinical and imaging interpretation was taken as a reference for the disease. A diagnostic accuracy comparison was done with the existing Hopkins score. Further effectiveness was analyzed with disease-free survival (DFI) and overall survival (OS). Results: Metastasis was developed in 11/83 patients at 3 months of evaluation. Of 72 patients, 39, 2, and 31 patients had a complete response, equivocal response, and partial response as per HAN-MI-RADS. Per patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting loco-regional disease up to 1 and 2 years was 93.3%, 92.5%, 90.3%, 94.9%, 92.9%, and 84.9%, 91.9%, 90.3%, 87.2%, and 88.6% respectively. One year and two years DFI for each HAN-MI-RADS score showed a statistically significant difference while it was not for OS. The receiver operating characteristic curve analysis showed significantly better outcome predictability of HAN-MI-RADS (area under the curve [AUC] 0.884) than Hopkins (AUC 0.699). Conclusions: A five points HAN-MI-RADS criterion was found promising for response assessment with less equivocal results and statistically significant higher AUC than Hopkins for loco-regional recurrence prediction. Keywords: Concurrent chemo-radiotherapy, head-and-neck molecular imaging-reporting and data system, head-and-neck squamous cell carcinoma, Hopkins score, molecular response Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations were needed. We tested the effectiveness of a proposed semi-quantitative molecular response criterion in these patients. Two subspecialty-trained physicians evaluated [sup.18]F-fluorodeoxyglucose positron emission tomography/computed tomography of LA-HNSCC patients (n = 83) post 3 months CRT using a five points Head and Neck Molecular Imaging-Reporting and Data System (HAN-MI-RADS) criterion. Where available, histopathology examination with clinical and imaging interpretation was taken as a reference for the disease. A diagnostic accuracy comparison was done with the existing Hopkins score. Further effectiveness was analyzed with disease-free survival (DFI) and overall survival (OS). Metastasis was developed in 11/83 patients at 3 months of evaluation. Of 72 patients, 39, 2, and 31 patients had a complete response, equivocal response, and partial response as per HAN-MI-RADS. Per patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting loco-regional disease up to 1 and 2 years was 93.3%, 92.5%, 90.3%, 94.9%, 92.9%, and 84.9%, 91.9%, 90.3%, 87.2%, and 88.6% respectively. One year and two years DFI for each HAN-MI-RADS score showed a statistically significant difference while it was not for OS. The receiver operating characteristic curve analysis showed significantly better outcome predictability of HAN-MI-RADS (area under the curve [AUC] 0.884) than Hopkins (AUC 0.699). A five points HAN-MI-RADS criterion was found promising for response assessment with less equivocal results and statistically significant higher AUC than Hopkins for loco-regional recurrence prediction. Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations were needed. We tested the effectiveness of a proposed semi-quantitative molecular response criterion in these patients.PurposePostconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations were needed. We tested the effectiveness of a proposed semi-quantitative molecular response criterion in these patients.Two subspecialty-trained physicians evaluated 18F-fluorodeoxyglucose positron emission tomography/computed tomography of LA-HNSCC patients (n = 83) post 3 months CRT using a five points Head and Neck Molecular Imaging-Reporting and Data System (HAN-MI-RADS) criterion. Where available, histopathology examination with clinical and imaging interpretation was taken as a reference for the disease. A diagnostic accuracy comparison was done with the existing Hopkins score. Further effectiveness was analyzed with disease-free survival (DFI) and overall survival (OS).Materials and MethodsTwo subspecialty-trained physicians evaluated 18F-fluorodeoxyglucose positron emission tomography/computed tomography of LA-HNSCC patients (n = 83) post 3 months CRT using a five points Head and Neck Molecular Imaging-Reporting and Data System (HAN-MI-RADS) criterion. Where available, histopathology examination with clinical and imaging interpretation was taken as a reference for the disease. A diagnostic accuracy comparison was done with the existing Hopkins score. Further effectiveness was analyzed with disease-free survival (DFI) and overall survival (OS).Metastasis was developed in 11/83 patients at 3 months of evaluation. Of 72 patients, 39, 2, and 31 patients had a complete response, equivocal response, and partial response as per HAN-MI-RADS. Per patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting loco-regional disease up to 1 and 2 years was 93.3%, 92.5%, 90.3%, 94.9%, 92.9%, and 84.9%, 91.9%, 90.3%, 87.2%, and 88.6% respectively. One year and two years DFI for each HAN-MI-RADS score showed a statistically significant difference while it was not for OS. The receiver operating characteristic curve analysis showed significantly better outcome predictability of HAN-MI-RADS (area under the curve [AUC] 0.884) than Hopkins (AUC 0.699).ResultsMetastasis was developed in 11/83 patients at 3 months of evaluation. Of 72 patients, 39, 2, and 31 patients had a complete response, equivocal response, and partial response as per HAN-MI-RADS. Per patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting loco-regional disease up to 1 and 2 years was 93.3%, 92.5%, 90.3%, 94.9%, 92.9%, and 84.9%, 91.9%, 90.3%, 87.2%, and 88.6% respectively. One year and two years DFI for each HAN-MI-RADS score showed a statistically significant difference while it was not for OS. The receiver operating characteristic curve analysis showed significantly better outcome predictability of HAN-MI-RADS (area under the curve [AUC] 0.884) than Hopkins (AUC 0.699).A five points HAN-MI-RADS criterion was found promising for response assessment with less equivocal results and statistically significant higher AUC than Hopkins for loco-regional recurrence prediction.ConclusionsA five points HAN-MI-RADS criterion was found promising for response assessment with less equivocal results and statistically significant higher AUC than Hopkins for loco-regional recurrence prediction. Purpose: Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations were needed. We tested the effectiveness of a proposed semi-quantitative molecular response criterion in these patients. Materials and Methods: Two subspecialty-trained physicians evaluated 18F-fluorodeoxyglucose positron emission tomography/computed tomography of LA-HNSCC patients (n = 83) post 3 months CRT using a five points Head and Neck Molecular Imaging-Reporting and Data System (HAN-MI-RADS) criterion. Where available, histopathology examination with clinical and imaging interpretation was taken as a reference for the disease. A diagnostic accuracy comparison was done with the existing Hopkins score. Further effectiveness was analyzed with disease-free survival (DFI) and overall survival (OS). Results: Metastasis was developed in 11/83 patients at 3 months of evaluation. Of 72 patients, 39, 2, and 31 patients had a complete response, equivocal response, and partial response as per HAN-MI-RADS. Per patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting loco-regional disease up to 1 and 2 years was 93.3%, 92.5%, 90.3%, 94.9%, 92.9%, and 84.9%, 91.9%, 90.3%, 87.2%, and 88.6% respectively. One year and two years DFI for each HAN-MI-RADS score showed a statistically significant difference while it was not for OS. The receiver operating characteristic curve analysis showed significantly better outcome predictability of HAN-MI-RADS (area under the curve [AUC] 0.884) than Hopkins (AUC 0.699). Conclusions: A five points HAN-MI-RADS criterion was found promising for response assessment with less equivocal results and statistically significant higher AUC than Hopkins for loco-regional recurrence prediction. Purpose: Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to prevailing postradiation changes. Molecular response methods have been encouraging, although further clarifications and validations were needed. We tested the effectiveness of a proposed semi-quantitative molecular response criterion in these patients. Materials and Methods: Two subspecialty-trained physicians evaluated 18F-fluorodeoxyglucose positron emission tomography/computed tomography of LA-HNSCC patients (n = 83) post 3 months CRT using a five points Head and Neck Molecular Imaging-Reporting and Data System (HAN-MI-RADS) criterion. Where available, histopathology examination with clinical and imaging interpretation was taken as a reference for the disease. A diagnostic accuracy comparison was done with the existing Hopkins score. Further effectiveness was analyzed with disease-free survival (DFI) and overall survival (OS). Results: Metastasis was developed in 11/83 patients at 3 months of evaluation. Of 72 patients, 39, 2, and 31 patients had a complete response, equivocal response, and partial response as per HAN-MI-RADS. Per patient sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting loco-regional disease up to 1 and 2 years was 93.3%, 92.5%, 90.3%, 94.9%, 92.9%, and 84.9%, 91.9%, 90.3%, 87.2%, and 88.6% respectively. One year and two years DFI for each HAN-MI-RADS score showed a statistically significant difference while it was not for OS. The receiver operating characteristic curve analysis showed significantly better outcome predictability of HAN-MI-RADS (area under the curve [AUC] 0.884) than Hopkins (AUC 0.699). Conclusions: A five points HAN-MI-RADS criterion was found promising for response assessment with less equivocal results and statistically significant higher AUC than Hopkins for loco-regional recurrence prediction. |
| Audience | Academic |
| Author | Goyal, Sumit Ahlawat, Parveen Mehta, Parv Jajodia, Ankush Gairola, Munish Agarwal, Mudit Choudhury, Partha Sarathi Gupta, Manoj |
| AuthorAffiliation | 3 Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India 2 Department of Radiotherapy, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India 1 Department of Radiology, Juravinski Hospital, McMaster University, Hamilton, Canada Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India 4 Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38390552$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1007/s00259-011-1893-y 10.1200/JCO.2017.73.5845 10.1016/j.jacr.2018.05.006 10.1016/S0140-6736(19)30956-0 10.2214/AJR.17.18301 10.3322/caac.21660 10.2967/jnumed.113.136796 10.2214/AJR.19.22642 10.3322/caac.21332 10.1016/j.radonc.2020.03.032 10.1002/hed.27160 10.1038/s41598-020-60739-3 10.1007/s12149-018-1291-7 10.1007/s00259-014-2961-x 10.1056/NEJMoa1514493 10.1016/j.ejca.2008.10.026 |
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| Keywords | Concurrent chemo-radiotherapy Hopkins score molecular response head-and-neck squamous cell carcinoma head-and-neck molecular imaging-reporting and data system |
| Language | English |
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| References_xml | – volume: 38 start-page: 2083 year: 2011 ident: R6-20240902 article-title: Diagnostic performance of post-treatment FDG PET or FDG PET/CT imaging in head and neck cancer: A systematic review and meta-analysis publication-title: Eur J Nucl Med Mol Imaging doi: 10.1007/s00259-011-1893-y – volume: 35 start-page: 3458 year: 2017 ident: R9-20240902 article-title: Fluorodeoxyglucose-positron emission tomography/computed tomography after concurrent chemoradiotherapy in locally advanced head-and-neck squamous cell cancer: The ECLYPS study publication-title: J Clin Oncol doi: 10.1200/JCO.2017.73.5845 – volume: 15 start-page: 1097 year: 2018 ident: R13-20240902 article-title: ACR neck imaging reporting and data systems (NI-RADS): A white paper of the ACR NI-RADS committee publication-title: J Am Coll Radiol doi: 10.1016/j.jacr.2018.05.006 – volume: 394 start-page: 64 year: 2019 ident: R15-20240902 article-title: Nasopharyngeal carcinoma publication-title: Lancet doi: 10.1016/S0140-6736(19)30956-0 – volume: 209 start-page: 289 year: 2017 ident: R3-20240902 article-title: Clinical practice in PET/CT for the management of head and neck squamous cell cancer publication-title: AJR Am J Roentgenol doi: 10.2214/AJR.17.18301 – volume: 71 start-page: 209 year: 2021 ident: R1-20240902 article-title: Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries publication-title: CA Cancer J Clin doi: 10.3322/caac.21660 – volume: 55 start-page: 1411 year: 2014 ident: R8-20240902 article-title: Head and neck PET/CT: Therapy response interpretation criteria (Hopkins Criteria)-interreader reliability, accuracy, and survival outcomes publication-title: J Nucl Med doi: 10.2967/jnumed.113.136796 – volume: 215 start-page: 313 year: 2020 ident: R12-20240902 article-title: It’s about quality, not quantity: Qualitative FDG PET/CT criteria for therapy response assessment in clinical practice publication-title: AJR Am J Roentgenol doi: 10.2214/AJR.19.22642 – volume: 66 start-page: 7 year: 2016 ident: R2-20240902 article-title: Cancer statistics, 2016 publication-title: CA Cancer J Clin doi: 10.3322/caac.21332 – volume: 148 start-page: 14 year: 2020 ident: R16-20240902 article-title: FDG-PET/CT scan assessment of response 12 weeks post radical radiotherapy in oropharynx head and neck cancer: The impact of p16 status publication-title: Radiother Oncol doi: 10.1016/j.radonc.2020.03.032 – volume: 44 start-page: 2491 year: 2022 ident: R14-20240902 article-title: Posttreatment FDG-PET/CT Hopkins criteria predict locoregional recurrence after definitive radiotherapy for oropharyngeal squamous cell carcinoma publication-title: Head Neck doi: 10.1002/hed.27160 – volume: 10 start-page: 4086 year: 2020 ident: R11-20240902 article-title: Post-treatment FDG PET-CT in head and neck carcinoma: Comparative analysis of 4 qualitative interpretative criteria in a large patient cohort publication-title: Sci Rep doi: 10.1038/s41598-020-60739-3 – volume: 32 start-page: 512 year: 2018 ident: R5-20240902 article-title: Molecular imaging reporting and data systems (MI-RADS): A generalizable framework for targeted radiotracers with theranostic implications publication-title: Ann Nucl Med doi: 10.1007/s12149-018-1291-7 – volume: 42 start-page: 328 year: 2015 ident: R7-20240902 article-title: FDG PET/CT: EANM procedure guidelines for tumour imaging: Version 2.0 publication-title: Eur J Nucl Med Mol Imaging doi: 10.1007/s00259-014-2961-x – volume: 374 start-page: 1444 year: 2016 ident: R4-20240902 article-title: PET-CT surveillance versus neck dissection in advanced head and neck cancer publication-title: N Engl J Med doi: 10.1056/NEJMoa1514493 – volume: 45 start-page: 228 year: 2009 ident: R10-20240902 article-title: New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1) publication-title: Eur J Cancer doi: 10.1016/j.ejca.2008.10.026 |
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Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC)... Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC) due to... Purpose: Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC)... Purpose:Postconcurrent chemoradiotherapy (CRT) response assessment has been challenging in locally advanced head-and-neck squamous cell carcinoma (LA-HNSCC)... |
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| SubjectTerms | Cancer Chemotherapy Computed tomography Criteria Data systems Effectiveness Emission analysis Evaluation Head & neck cancer Medical imaging Medical research Medicine, Experimental Original Original Article Positron emission Radiation therapy Regional analysis Squamous cell carcinoma Survival Tomography |
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| Title | Effectiveness of Head-and-Neck Molecular Imaging Reporting and Data System Criterion in Head-and-Neck Squamous Cell Carcinoma PostConcurrent Chemoradiotherapy |
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