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@ARTICLE{Carles:169963,
      author       = {M. Carles$^*$ and T. Fechter$^*$ and A. L. Grosu$^*$ and A.
                      Sörensen$^*$ and B. Thomann$^*$ and R. Stoian$^*$ and N.
                      Wiedenmann$^*$ and A. Rühle$^*$ and C. Zamboglou$^*$ and J.
                      Ruf$^*$ and L. Martí-Bonmatí and D. Baltas$^*$ and M.
                      Mix$^*$ and N. H. Nicolay$^*$},
      title        = {18{F}-{FMISO}-{PET} {H}ypoxia {M}onitoring for
                      {H}ead-and-{N}eck {C}ancer {P}atients: {R}adiomics
                      {A}nalyses {P}redict the {O}utcome of
                      {C}hemo-{R}adiotherapy.},
      journal      = {Cancers},
      volume       = {13},
      number       = {14},
      issn         = {2072-6694},
      address      = {Basel},
      publisher    = {MDPI},
      reportid     = {DKFZ-2021-01663},
      pages        = {3449},
      year         = {2021},
      abstract     = {Tumor hypoxia is associated with radiation resistance and
                      can be longitudinally monitored by 18F-fluoromisonidazole
                      (18F-FMISO)-PET/CT. Our study aimed at evaluating radiomics
                      dynamics of 18F-FMISO-hypoxia imaging during
                      chemo-radiotherapy (CRT) as predictors for treatment outcome
                      in head-and-neck squamous cell carcinoma (HNSCC) patients.
                      We prospectively recruited 35 HNSCC patients undergoing
                      definitive CRT and longitudinal 18F-FMISO-PET/CT scans at
                      weeks 0, 2 and 5 (W0/W2/W5). Patients were classified based
                      on peritherapeutic variations of the hypoxic sub-volume
                      (HSV) size (increasing/stable/decreasing) and location
                      (geographically-static/geographically-dynamic) by a new
                      objective classification parameter (CP) accounting for
                      spatial overlap. Additionally, 130 radiomic features (RF)
                      were extracted from HSV at W0, and their variations during
                      CRT were quantified by relative deviations (∆RF).
                      Prediction of treatment outcome was considered statistically
                      relevant after being corrected for multiple testing and
                      confirmed for the two 18F-FMISO-PET/CT time-points and for a
                      validation cohort. HSV decreased in $64\%$ of patients at W2
                      and in $80\%$ at W5. CP distinguished earlier disease
                      progression (geographically-dynamic) from later disease
                      progression (geographically-static) in both time-points and
                      cohorts. The texture feature low grey-level zone emphasis
                      predicted local recurrence with AUCW2 = 0.82 and AUCW5 =
                      0.81 in initial cohort (N = 25) and AUCW2 = 0.79 and AUCW5 =
                      0.80 in validation cohort. Radiomics analysis of
                      18F-FMISO-derived hypoxia dynamics was able to predict
                      outcome of HNSCC patients after CRT.},
      keywords     = {18F-FMISO-PET (Other) / head-and-neck squamous cell
                      carcinoma and radiomics (Other) / hypoxia (Other) /
                      radiotherapy response monitoring (Other)},
      cin          = {FR01 / E055},
      ddc          = {610},
      cid          = {I:(DE-He78)FR01-20160331 / I:(DE-He78)E055-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34298663},
      doi          = {10.3390/cancers13143449},
      url          = {https://inrepo02.dkfz.de/record/169963},
}