Metabolic imaging biomarkers of postradiotherapy xerostomia

Blake Cannon, David Schwartz, Lei Dong

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: Xerostomia is a major complication of head and neck radiotherapy (RT). Available xerostomia measures remain flawed. [ 18F] fluorodeoxyglucose-labeled positron emission tomography-computed tomography (FDG-PET-CT) is routinely used for staging and response assessment of head and neck cancer. We investigated quantitative measurement of parotid gland FDG uptake as a potential biomarker for post-RT xerostomia. Methods and Materials: Ninety-eight locally advanced head and neck cancer patients receiving definitive RT underwent baseline and post-RT FDG-PET-CT on a prospective imaging trial. A separate validation cohort of 14 patients underwent identical imaging while prospectively enrolled in a second trial collecting sialometry and patient-reported outcomes. Radiation dose and pre- and post-RT standard uptake values (SUVs) for all voxels contained within parotid gland ROI were deformably registered. Results: Average whole-gland or voxel-by-voxel models incorporating parotid D Met (defined as the pretreatment parotid SUV weighted by dose) accurately predicted posttreatment changes in parotid FDG uptake (e.g., fractional parotid SUV). Fractional loss of parotid FDG uptake closely paralleled early parotid toxicity defined by posttreatment salivary output (p < 0.01) and Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer xerostomia scores (p < 0.01). Conclusions: In this pilot series, loss of parotid FDG uptake was strongly associated with acute clinical post-RT parotid toxicity. D Met may potentially be used to guide function-sparing treatment planning. Prospective validation of FDG-PET-CT as a convenient, quantifiable imaging biomarker of parotid function is warranted and ongoing.

Original languageEnglish (US)
Pages (from-to)1609-1616
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume83
Issue number5
DOIs
StatePublished - Aug 1 2012

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Xerostomia
biomarkers
radiation therapy
Radiotherapy
Biomarkers
tomography
salivary glands
positrons
cancer
Parotid Gland
Head and Neck Neoplasms
toxicity
dosage
glands
Radiation Oncology
Fluorodeoxyglucose F18
pretreatment
planning
Neck
Head

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Metabolic imaging biomarkers of postradiotherapy xerostomia. / Cannon, Blake; Schwartz, David; Dong, Lei.

In: International Journal of Radiation Oncology Biology Physics, Vol. 83, No. 5, 01.08.2012, p. 1609-1616.

Research output: Contribution to journalArticle

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