Usefulness of 64Cu-ATSM in head and neck cancer: a preliminary prospective study.

Abstract

AIMS:

Cu-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) is a hypoxia-avid, positron emitter radiotracer. The primary aim of this study is to assess the efficacy of pretherapy Cu-ATSM PET/CT as a prognostic factor of response to therapy. The secondary aims are to investigate if there is a difference between early and late PET/CT scans and if there is a difference between the biologic tumor volume (BTV) in radiotherapy treatment planning calculated between Cu-ATSM and F-FDG, and to assess if Cu-ATSM is a prognostic marker of disease progression.

METHODS:

Eleven patients with head and neck cancer treated with chemoradiotherapy were enrolled prospectively; both Cu-ATSM and F-FDG PET/CT scans before and after treatment were obtained. The Cu-ATSM scans were performed after 1 hour (early) and 16 hours (late).

RESULTS:

All patients had stage III or IV squamous cell head and neck cancer; 7 of 11 patients had nodal metastasis, and 22 cancer foci were detected with Cu-ATSM. SUVmax was 16.2 ± 7.9, and there was no significant SUVmax difference between early and late imaging. F-FDG SUVmax before therapy was 15.6 ± 9.4, whereas F-FDG SUVmax after therapy was 1.5 ± 1.2. Sensitivity and specificity values of Cu-ATSM calculated with receiver operating characteristic curves were 100% and 50% considering the SUVmax and 100% and 33% considering the volume, respectively. No difference has been found between the BTV contoured with Cu-ATSM and F-FDG.

CONCLUSIONS:

The Cu-ATSM scans showed high sensitivity but low specificity in predicting neoadjuvant chemoradiotherapy response. No difference was noted between early and late scans. F-FDG and Cu-ATSM provided similar results about delineation of BTV.

• Authors: Ilaria Grassi, Cristina Nanni, Gianfranco Cicoria, Claudio Blasi, Feisal Bunkheila, Egesta Lopci, Patrick M Colletti, Domenico Rubello, Stefano Fanti
• Journal: Clinical nuclear medicine (Clin Nucl Med) Vol. 39 Issue 1 Pg. e59-63 (Jan 2014) ISSN: 1536-0229 [Electronic] United States
• PMID: 24097008 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Coordination Complexes
• Organometallic Compounds
• Thiosemicarbazones
• copper (II) diacetyl-di(N(4)-methylthiosemicarbazone)

Topics

• Coordination Complexes
• Female
• Head and Neck Neoplasms (diagnostic imaging, pathology)
• Humans
• Male
• Middle Aged
• Multimodal Imaging
• Organometallic Compounds
• Positron-Emission Tomography
• Prospective Studies
• Thiosemicarbazones
• Tomography, X-Ray Computed
• Tumor Burden