మా గ్రూప్ ప్రతి సంవత్సరం USA, యూరప్ & ఆసియా అంతటా 3000+ గ్లోబల్ కాన్ఫరెన్స్ ఈవెంట్లను నిర్వహిస్తుంది మరియు 1000 కంటే ఎక్కువ సైంటిఫిక్ సొసైటీల మద్దతుతో 700+ ఓపెన్ యాక్సెస్ జర్నల్లను ప్రచురిస్తుంది , ఇందులో 50000 మంది ప్రముఖ వ్యక్తులు, ప్రఖ్యాత శాస్త్రవేత్తలు ఎడిటోరియల్ బోర్డ్ సభ్యులుగా ఉన్నారు.
ఎక్కువ మంది పాఠకులు మరియు అనులేఖనాలను పొందే ఓపెన్ యాక్సెస్ జర్నల్స్
700 జర్నల్స్ మరియు 15,000,000 రీడర్లు ప్రతి జర్నల్ 25,000+ రీడర్లను పొందుతున్నారు
Albert J Chang, Farrokh Dehdashti, Barry A Siegel, Michael J Welch, Julie K Schwarz and Perry W Grigsby
Introduction: Intratumoral heterogeneity determined by FDG-PET is a poor prognostic factor in cervical cancer. Cu-
ATSM has been used to evaluate hypoxia in cervical cancer. In this study, FDG and 64Cu-ATSM uptake patterns were compared and the prognostic significance of 64Cu-ATSM heterogeneity was determined. Methods: 15 patients with cervical cancer who underwent pretreatment 64Cu-ATSM- and FDG-PET/CT were included. The 64Cu-ATSM- and FDG-PET/CT images were co-registered and tumor volumes were autocontoured for each image set in 10% increments of the SUVmax ranging from 40% to 80%. The hypoxic fraction defined by 64Cu-ATSM uptake was determined. Concordance between 64Cu-ATSM and FDG uptake was determined by Dice’s coefficient. Heterogeneity of 64Cu-ATSM and FDG uptake was calculated as the variance of the 40-80% isothreshold volumes. The association between heterogeneity of 64Cu-ATSM uptake with tumor-specific factors and outcomes was determined. Results: The hypoxic fraction ranged from 0.773 ± 0.013 to 0.087 ± 0.010 as defined by the 40% to 80% Cu-ATSM isothreshold volumes, respectively. Dice’s similarity coefficients for the FDG and 64Cu-ATSM 40 to 80% isothreshold volumes ranged from 0.476 ± 0.012 to 0.112 ± 0.017. Greater 64Cu-ATSM heterogeneity was associated with increased risk of lymph node metastasis at diagnosis (p<0.01), persistent disease after therapy, (p<0.01), and decreased median progression-free survival (11 months vs. not reached, p=0.03). Conclusion: Significant fractions of cervical tumors are hypoxic. Regions of highest 64Cu-ATSM and FDG uptake were discordant. Elevated 64Cu-ATSM heterogeneity may predict for increased risk of lymph node metastases, decreased responsiveness to treatment, and decreased progression-free survival.