Skip to main content
SpringerLink
Log in

Dosimetry study of 18F-FMISO + PET/CT hypoxia imaging guidance on intensity-modulated radiation therapy for non-small cell lung cancer

  • Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Objectives

This study was to evaluate the feasibility of simultaneous integrated boost on tumor hypoxia area by studying the dosimetric change of hypoxia imaging guidance on intensity-modulated radiation therapy for non-small cell lung cancer (NSCLC).

Methods

Five NSCLC patients with large hypoxic volume participated in this study. FDG PET/CT images were fused with CT localization images to delineate gross tumor volume. FMISO PET/CT images were fused with CT localization images to delineate hypoxic biological target volume (BTV) (tissue maximum ratio ≥ 1.3) by threshold. BTV was irradiated with 72, 78 and 84 Gy, respectively, 30 times. The dosimetry differences were compared in target volume and organ at risk between simultaneous integrated boost plans and conventional radiotherapy plans.

Results

Dosages on BTV of NSCLC hypoxic area were increased to 72, 78 and 84 Gy, respectively, by simultaneous integrated boost intensity-modulated radiation therapy. There was no obvious difference in dosage distributions on original target volume compared with those in conventional radiotherapy. Dosages on main organ at risk in chest met the dosimetric constraint, and there was no significant difference compared with those in conventional radiotherapy.

Conclusion

It is feasible in dosiology that the dosages in NSCLC hypoxic area were added to 72, 78 and 84 Gy by simultaneous integrated boost with the guidance of 18F-FMISO PET/CT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Torre LA, Bray F, Siegel RL, Ferlay J. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108.

    Article  Google Scholar 

  2. Travis WD, Brambilla E, Riely GJ. New pathologic classification of lung cancer: relevance for clinical practice and clinical trials. J Clin Oncol. 2013;31(8):992–1001.

    Article  CAS  Google Scholar 

  3. Li L, Hu M, Zhu H, Yang G, Yu J. Comparison of 18F-fluoroerythronitroimidazole and 18F-fluorodeoxyglucose positron emission tomography and prognostic value in locally advanced non-small-cell lung cancer. Clin Lung Cancer. 2010;11(5):335–40.

    Article  Google Scholar 

  4. Thomlinson RH, Gray LH. The histological structure of some human lung cancers and the possible implications for radiotherapy. Br J Cancer. 1955;9(4):539.

    Article  CAS  Google Scholar 

  5. Eschmann SM, Paulsen F, Reimold M, Dittmann H, Welz S, Reischl G, et al. Prognostic impact of hypoxia imaging with 18F-misonidazole PET in non-small cell lung cancer and head and neck cancer before radiotherapy. J Nucl Med. 2005;46(2):253–60.

    PubMed  Google Scholar 

  6. Zimny M, Gagel B, DiMartino E, Hamacher K, Coenen HH, Westhofen M, et al. FDG—a marker of tumour hypoxia? A comparison with [18F] fluoromisonidazole and pO2-polarography in metastatic head and neck cancer. Eur J Nucl Med Mol Imaging. 2006;33(12):1426–31.

    Article  CAS  Google Scholar 

  7. Gagel B, Reinartz P, Dimartino E, Eble MJ. pO2 polarography versus positron emission tomography ([(18)F] fluoromisonidazole, [(18)F]-2-fluoro-2′-deoxyglucose). An appraisal of radiotherapeutically relevant hypoxia. Strahlenther Onkol. 2004;180(10):616–22.

    Article  Google Scholar 

  8. Bowen SR, Kogel AJVD, Nordsmark M, Bentzen SM, Jeraj R. Characterization of positron emission tomography hypoxia tracer uptake and tissue oxygenation via electrochemical modeling. Nucl Med Biol. 2011;38(6):771–80.

    Article  CAS  Google Scholar 

  9. Brustugun OT. Hypoxia as a cause of treatment failure in non-small cell carcinoma of the lung. Semin Radiat Oncol. 2015;25(2):87–92.

    Article  Google Scholar 

  10. Popple RA, Ove R, Shen S. Tumor control probability for selective boosting of hypoxic subvolumes, including the effect of reoxygenation. Int J Radiat Oncol Biol Phys. 2002;54(3):921–7.

    Article  Google Scholar 

  11. Corvo R, Santoni R, Magrini SM, Maurizi ER. Radiobiology as a basic and clinical medical science: what the physicists have forgotten. Tumori. 2016;102(1):e8.

    Article  CAS  Google Scholar 

  12. Henk JM, Smith CW. Radiotherapy and hyperbaric oxygen in head and neck cancer. Interim report of second clinical trial. Lancet. 1977;2(8029):104–5.

    Article  CAS  Google Scholar 

  13. Cade IS, McEwen JB, Dische S, Saunders MI, Watson ER, Halnan KE, et al. Hyperbaric oxygen and radiotherapy: a Medical Research Council trial in carcinoma of the bladder. Br J Radiol. 1978;51(611):876–8.

    Article  CAS  Google Scholar 

  14. Overgaard J. Clinical evaluation of nitroimidazoles as modifiers of hypoxia in solid tumors. Oncol Res. 1994;6(10–11):509–18.

    PubMed  CAS  Google Scholar 

  15. Grau C, Prakash Agarwal J, Jabeen K, Rab Khan A, Abeyakoon S, Hadjieva T, et al. Radiotherapy with or without mitomycin c in the treatment of locally advanced head and neck cancer: results of the IAEA multicentre randomised trial. Radiother Oncol. 2003;67(1):17–26.

    Article  Google Scholar 

  16. Lardinois D, Weder W, Hany TF, Kamel EM, Korom S, Seifert B, et al. Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med. 2003;348(25):2500–7.

    Article  Google Scholar 

  17. Chang JH, Wada M, Anderson NJ, Lim Joon D, Lee ST, Gong SJ, et al. Hypoxia-targeted radiotherapy dose painting for head and neck cancer using (18) F-FMISO PET: a biological modeling study. Acta Oncol. 2013;52:1723–9.

    Article  CAS  Google Scholar 

  18. Bartlett RM, Beattie BJ, Naryanan M, Georgi JC, Chen Q, Carlin SD, et al. Image-guided pO2 probe measurements correlated with parametric images derived from 18F-fluoromisonidazole small-animal PET data in rats. J Nucl Med. 2012;53:1608–15.

    Article  CAS  Google Scholar 

  19. Koch CJ, Giandomenico AR, Iyengar CW. Bioreductive metabolism of AF-2[2-(2-furyl)-3-(5-nitro-2-furyl)acrylamide] combined with 2-nitroimidazoles. Implications for use as hypoxic cell markers. Biochem Pharmacol. 1993;46:1029–36.

    Article  CAS  Google Scholar 

  20. Mortensen LS, Johansen J, Kallehauge J, Primdahl H, Busk M, Lassen P, et al. FAZA PET/CT hypoxia imaging in patients with squamous cell carcinoma of the head and neck treated with radiotherapy: results from the DAHANCA 24 trial. Radiother Oncol. 2012;105:14–20.

    Article  Google Scholar 

  21. Bentzen SM, Gregoire V. Molecular imaging-based dose painting: a novel paradigm for radiation therapy prescription. Semin Radiat Oncol. 2011;21(2):101–10.

    Article  Google Scholar 

  22. Sovik A, Malinen E, Olsen DR. Strategies for biologic image-guided dose escalation: a review. Int J Radiat Oncol Biol Phys. 2009;73(3):650–8.

    Article  Google Scholar 

  23. Christian JA, Bedford JL, Webb S, Brada M. Comparison of inverse-planned three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2007;67(3):735–41.

    Article  Google Scholar 

  24. Yom SS, Liao Z, Liu HH, Tucker SL, Hu CS, Wei X, et al. Initial evaluation of treatment-related pneumonitis in advanced-stage non-small-cell lung cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys. 2007;68(1):94–102.

    Article  CAS  Google Scholar 

  25. Palma DA, Senan S, Oberije C, Belderbos J, de Dios NR, Bradley JD, et al. Predicting esophagitis after chemoradiation therapy for non-small cell lung cancer: an individual patient data meta-analysis. Int J Radiat Oncol Biol Phys. 2013;87(4):690–6.

    Article  Google Scholar 

Download references

Funding

This study was supported by Henan Provincial Department of Science, China, 142102310052.

Author information

Author notes

  1. H. Li and D. Xu are co-first authors.

  2. X. Han, Q. Ruan, X. Zhang, Y. Mi, M. Dong, S. Guo, Y. Lin, B. Wang and G. Li made equal contributions to this research.

Authors and Affiliations

  1. Radiotherapy Department, The First Affiliated Hospital of Zhengzhou University, 1 Eastern Jianshe Road, Zhengzhou, 450052, Henan, China

    H. Li, D. Xu, X. Zhang, Y. Mi, M. Dong, Y. Lin, B. Wang & G. Li

  2. Nuclear Medicine Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    X. Han & Q. Ruan

  3. Radiotherapy Department, Zhengzhou Central Hospital, Zhengzhou, China

    S. Guo

Authors
  1. H. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. X. Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Q. Ruan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. X. Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Y. Mi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Dong
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S. Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Y. Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. B. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. G. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Li.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of The First Affiliated Hospital of Zhengzhou University.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, H., Xu, D., Han, X. et al. Dosimetry study of 18F-FMISO + PET/CT hypoxia imaging guidance on intensity-modulated radiation therapy for non-small cell lung cancer. Clin Transl Oncol 20, 1329–1336 (2018). https://doi.org/10.1007/s12094-018-1864-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-018-1864-x

Keywords

Search

Navigation