Dose escalation to high-risk sub-volumes based on non-invasive imaging of hypoxia and glycolytic activity in canine solid tumors : A feasibility study

Clausen, Malene M.; Hansen, Anders E.; af Rosenschold, Per M.; Kjær, Andreas; Kristensen, Annemarie T.; McEvoy, Fintan J.; Engelholm, Svend A.

Dose escalation to high-risk sub-volumes based on non-invasive imaging of hypoxia and glycolytic activity in canine solid tumors : A feasibility study

Mark

Clausen, Malene M. ; Hansen, Anders E. ; af Rosenschold, Per M. ^LU

; Kjær, Andreas ; Kristensen, Annemarie T. ; McEvoy, Fintan J. and Engelholm, Svend A. (2013) In Radiation Oncology 8(1).

Abstract: Introduction: Glycolytic activity and hypoxia are associated with poor prognosis and radiation resistance. Including both the tumor uptake of 2-deoxy-2-[¹⁸ F]-fluorodeoxyglucose (FDG) and the proposed hypoxia tracer copper(II)diacetyl-bis(N⁴)-methylsemithio-carbazone (Cu-ATSM) in targeted therapy planning may therefore lead to improved tumor control. In this study we analyzed the overlap between sub-volumes of FDG and hypoxia assessed by the uptake of ⁶⁴Cu-ATSM in canine solid tumors, and evaluated the possibilities for dose redistribution within the gross tumor volume (GTV).Materials and methods: Positron emission tomography/computed tomography (PET/CT) scans of five spontaneous canine solid tumors were... (More); Introduction: Glycolytic activity and hypoxia are associated with poor prognosis and radiation resistance. Including both the tumor uptake of 2-deoxy-2-[¹⁸ F]-fluorodeoxyglucose (FDG) and the proposed hypoxia tracer copper(II)diacetyl-bis(N⁴)-methylsemithio-carbazone (Cu-ATSM) in targeted therapy planning may therefore lead to improved tumor control. In this study we analyzed the overlap between sub-volumes of FDG and hypoxia assessed by the uptake of ⁶⁴Cu-ATSM in canine solid tumors, and evaluated the possibilities for dose redistribution within the gross tumor volume (GTV).Materials and methods: Positron emission tomography/computed tomography (PET/CT) scans of five spontaneous canine solid tumors were included. FDG-PET/CT was obtained at day 1, ⁶⁴Cu-ATSM at day 2 and 3 (3 and 24 h pi.). GTV was delineated and CT images were co-registered. Sub-volumes for 3 h and 24 h ⁶⁴Cu-ATSM (Cu3 and Cu24) were defined by a threshold based method. FDG sub-volumes were delineated at 40% (FDG40) and 50% (FDG50) of SUV_max. The size of sub-volumes, intersection and biological target volume (BTV) were measured in a treatment planning software. By varying the average dose prescription to the tumor from 66 to 85 Gy, the possible dose boost (D_B) was calculated for the three scenarios that the optimal target for the boost was one, the union or the intersection of the FDG and ⁶⁴Cu-ATSM sub-volumes.Results: The potential boost volumes represented a fairly large fraction of the total GTV: Cu3 49.8% (26.8-72.5%), Cu24 28.1% (2.4-54.3%), FDG40 45.2% (10.1-75.2%), and FDG50 32.5% (2.6-68.1%). A BTV including the union (∪) of Cu3 and FDG would involve boosting to a larger fraction of the GTV, in the case of Cu3∪FDG40 63.5% (51.8-83.8) and Cu3∪FDG50 48.1% (43.7-80.8). The union allowed only a very limited D_B whereas the intersection allowed a substantial dose escalation.Conclusions: FDG and ⁶⁴Cu-ATSM sub-volumes were only partly overlapping, suggesting that the tracers offer complementing information on tumor physiology. Targeting the combined PET positive volume (BTV) for dose escalation within the GTV results in a limited D_B. This suggests a more refined dose redistribution based on a weighted combination of the PET tracers in order to obtain an improved tumor control.
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Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/94c271d9-3f8e-404f-a77e-6738f1fa937c

author

Clausen, Malene M. ; Hansen, Anders E. ; af Rosenschold, Per M. ^LU

; Kjær, Andreas ; Kristensen, Annemarie T. ; McEvoy, Fintan J. and Engelholm, Svend A.

publishing date

2013-11-07

type

Contribution to journal

publication status

published

subject

Cancer and Oncology

in

Radiation Oncology

volume

8

issue

1

article number

262

publisher

BioMed Central (BMC)

external identifiers

pmid:24199939
scopus:84887339426

ISSN

1748-717X

DOI

10.1186/1748-717X-8-262

language

English

LU publication?

no

id

94c271d9-3f8e-404f-a77e-6738f1fa937c

date added to LUP

2023-07-19 17:11:38

date last changed

2024-01-05 03:34:13

@article{94c271d9-3f8e-404f-a77e-6738f1fa937c,
  abstract     = {{<p>Introduction: Glycolytic activity and hypoxia are associated with poor prognosis and radiation resistance. Including both the tumor uptake of 2-deoxy-2-[<sup>18</sup> F]-fluorodeoxyglucose (FDG) and the proposed hypoxia tracer copper(II)diacetyl-bis(N<sup>4</sup>)-methylsemithio-carbazone (Cu-ATSM) in targeted therapy planning may therefore lead to improved tumor control. In this study we analyzed the overlap between sub-volumes of FDG and hypoxia assessed by the uptake of <sup>64</sup>Cu-ATSM in canine solid tumors, and evaluated the possibilities for dose redistribution within the gross tumor volume (GTV).Materials and methods: Positron emission tomography/computed tomography (PET/CT) scans of five spontaneous canine solid tumors were included. FDG-PET/CT was obtained at day 1, <sup>64</sup>Cu-ATSM at day 2 and 3 (3 and 24 h pi.). GTV was delineated and CT images were co-registered. Sub-volumes for 3 h and 24 h <sup>64</sup>Cu-ATSM (Cu3 and Cu24) were defined by a threshold based method. FDG sub-volumes were delineated at 40% (FDG40) and 50% (FDG50) of SUV<sub>max</sub>. The size of sub-volumes, intersection and biological target volume (BTV) were measured in a treatment planning software. By varying the average dose prescription to the tumor from 66 to 85 Gy, the possible dose boost (D<sub>B</sub>) was calculated for the three scenarios that the optimal target for the boost was one, the union or the intersection of the FDG and <sup>64</sup>Cu-ATSM sub-volumes.Results: The potential boost volumes represented a fairly large fraction of the total GTV: Cu3 49.8% (26.8-72.5%), Cu24 28.1% (2.4-54.3%), FDG40 45.2% (10.1-75.2%), and FDG50 32.5% (2.6-68.1%). A BTV including the union (∪) of Cu3 and FDG would involve boosting to a larger fraction of the GTV, in the case of Cu3∪FDG40 63.5% (51.8-83.8) and Cu3∪FDG50 48.1% (43.7-80.8). The union allowed only a very limited D<sub>B</sub> whereas the intersection allowed a substantial dose escalation.Conclusions: FDG and <sup>64</sup>Cu-ATSM sub-volumes were only partly overlapping, suggesting that the tracers offer complementing information on tumor physiology. Targeting the combined PET positive volume (BTV) for dose escalation within the GTV results in a limited D<sub>B</sub>. This suggests a more refined dose redistribution based on a weighted combination of the PET tracers in order to obtain an improved tumor control.</p>}},
  author       = {{Clausen, Malene M. and Hansen, Anders E. and af Rosenschold, Per M. and Kjær, Andreas and Kristensen, Annemarie T. and McEvoy, Fintan J. and Engelholm, Svend A.}},
  issn         = {{1748-717X}},
  language     = {{eng}},
  month        = {{11}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Radiation Oncology}},
  title        = {{Dose escalation to high-risk sub-volumes based on non-invasive imaging of hypoxia and glycolytic activity in canine solid tumors : A feasibility study}},
  url          = {{http://dx.doi.org/10.1186/1748-717X-8-262}},
  doi          = {{10.1186/1748-717X-8-262}},
  volume       = {{8}},
  year         = {{2013}},
}

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Dose escalation to high-risk sub-volumes based on non-invasive imaging of hypoxia and glycolytic activity in canine solid tumors : A feasibility study