PO-120 Clinical impact of metabolic and anatomic imaging in nasopharyngeal carcinoma treated with chemo- radiotherapy S. Ghosh Laskar 1 , A. Pilar 1 , N. Purandare 2 , V. Rangarajan 2 , A. Budrukkar 1 , T. Gupta 1 , V. Murthy 1 1 Tata Memorial Hospital, Department of Radiation Oncology, Mumbai, India 2 Tata Memorial Hospital, Department of Bio Imaging, Mumbai, India Purpose/Objective: To correlate anatomic tumour volumes (gross tumour volumes) , maximum standardized uptake value (SUV max), metabolic tumour volume (MTV) and total lesional glycolysis (TLG) with loco regional control (LRC), disease-free survival (DFS), distant metastases free survival (DMFS) and overall survival (OS). Materials and Methods: Between 2008 and 2012, 61 patients treated with chemo-radiotherapy, were evaluated. Gross tumour volumes (GTV) were contoured on the contrast enhanced CT of the pre-treatment FDG-PET-CT. SUV max was automatically generated. MTVs were delineated on the pre- treatment FDG-PET-CT. MTVs were generated at different thresholds of absolute SUV (MTV2, 3, 4, 5) and percentage SUV max (MTV20, 30, 40, 50). TLG was calculated for each MTV (8, for each patient) as the product of the corresponding MTV and SUV mean. All parameters were generated separately for primary tumour (primary GTV/MTV) and nodal disease (nodal GTV/MTV) and combined to get a total volume (Total GTV/MTV). Post treatment FDG-PET-CT was utilized to assess response. In case of residual disease, GTV and MTV were generated for the residual disease. The impact of GTV, SUV max, MTV, TLG and post treatment metabolic response on LRC, DFS, DMFS and OS was evaluated. Results: Seventy seven percent patients had stage III/IV disease. At a median follow-up (FU) of 35 months (range 11- 87months), 3-year LRC, DFS, DMFS and OS were 87.0%, 71%, 82% and 89%, respectively. At last FU, 18 patients (29%) had failed, 7 had loco regional failure, 10 had distant metastases and 1 had a second primary. Seven patients died of disease. Median time to first failure was 9.5months (range 1-59 months). All MTVs correlated well with GTV (R 2 range 0.93-0.69); however the best correlation was seen with MTV 2.0. Of all the MTVs, highest statistical significance for prediction of outcomes was seen with absolute SUV of 2.0. Hence, all further results are restricted to MTV 2.0. On univariate analysis, nodal GTV, total GTV were significant predictors of DFS, DMFS and OS (hazard ratio range 1.15- 1.20, p value < 0.03).MTV node had an impact on DFS and DMFS (hazard ratio range 1.10-1.15 p value < 0.03) but no impact on OS. Total MTV had no impact on DFS and OS but showed an impact on DMFS (hazard ratio = 1.16, p value=0.001). Post treatment metabolic response (MR) had no impact on DFS, DMFS and OS but patients with partial MR (PMR) had a significantly poorer local control (91% vs. 67% p=0.042) and regional control (96% vs. 71% p=0.016) compared to patients with complete MR (CMR). There was a significant association between total MTV and MR, patients with PMR having higher mean MTV than patients with CMR (114.1 ±49.5 vs. 63.9 ± 52.6, p=0.003). Conclusions: Nodal volume and GTV significantly impact DFS, DMFS and OS. Total MTV has an impact on DMFS. PMR results in poor local and regional control. There is significant association between total MTV and MR, patients with PMR having higher MTV. PO-121 Computer-aided quantitative interpretation to HIF-1a, c- MYC and p53 expression in oral submucous fibrosis A. Anura 1 , S. Conjeti 2 , M. Pal 3 , R.R. Paul 3 , J. Chatterjee 1 1 Indian Institute of Technology Kharagpur, School of Medical Science and Technology, Kharagpur, India 2 Technische Universität München, Chair for Computer Aided Medical Procedures and Augmented Reality Fakulät für Informatik, Boltzmannstraße3 Garching bei München, Germany 3 Guru Nanak Institute of Dental Science and Research, Department of Oral and Maxillofacial Pathology, Kolkata, India Purpose/Objective: Oral submucous fibrosis (OSF), a high- risk precancerous condition embeds progressive fibrosis of lamina propria in association with chronic inflammation and atrophy of overlying epithelium. The development of epithelial hyperplasia is often observed during OSF progression. The disorganized complex interplay amongst various molecular markers (cellular proliferation-c-MYC, regulator of apoptosis-p53 and hypoxia- HIF-1α) could have crucial role in epithelial dysplasia and advancing malignant potentiality of OSF. Assessing molecular marker impact on precancer pathobiology with the help of computer-aided quantitative analysis framework would help in evaluating advancing states in OSF and could improve the diagnostic interpretation of malignant potentiality towards carcinoma. Materials and Methods: The expression of c-MYC, HIF-1α and p53 were evaluated in sixty eight biopsy sample of oral buccal mucosa (normal mucosa, OSF with hyperplasia and OSF with atrophic epithelium) by immunohistochemistry. The digital immunohistochemical microphotographs were used for image analysis which includes stain separation of an original chromogenic immunohistochemical image into haematoxylin counter-stain (blue) and immunoreaction product (brown diaminobenzadine; DAB) followed by quantification of DAB expression. Further, biologically relevant features of molecular expression (spatial distribution and intensity) were extracted considering biological sites (nuclear/cytoplasmic). The altered state and trends of relevant features characterizing the diseased condition are statistically evaluated by Mann-Whitney U-Test and Spearman's rank correlation coefficient. Results In this study, an increased HIF-1α expression in epithelium and sub-epithelium was observed in OSF in comparison to NOM. c-MYC + nuclei were restricted to basal layers of epithelium in NOM. OSF with atrophic epithelium showed a reduction in expression intensity of c-MYC, whereas the upper epithelial layer showed c-MYC + expression along with significant increase in expression intensity in hyperplastic epithelium. On observing p53 expression in OSF with atrophic epithelium, it was found that density as well as intensity of its expression was significantly higher in atrophic epithelium to that of hyperplasic epithelium. The expression of p53 depicted a negative correlation with c-MYC in atrophic and hyperplasic epithelium of OSF. Conclusions: The incorporation of both intensity and spatial features into the proposed quantitative IHC scoring system led to a greater diagnostic value and may help in decision making for marker discovery. Through the above analysis, it has been postulated that, c-MYC, p53 and HIF-1α could have emerged as potential screening markers. Along with that, vital role of dysregulation of antagonist expression of c-Myc and p53 in oral epithelium in development of hyperplasic/atrophic epithelium during OSF Progression cannot be denied. 5TH ICHNO page 59