Korean J Radiol.  2012 Dec;13(6):752-759. 10.3348/kjr.2012.13.6.752.

Prognostic Value of Volume-Based 18F-Fluorodeoxyglucose PET/CT Parameters in Patients with Clinically Node-Negative Oral Tongue Squamous Cell Carcinoma

• Lee SJ
• Choi JY
• Lee HJ
• Baek CH
• Son YI
• Hyun SH
• Moon SH
• Kim BT

• KMID: 1397506
• DOI: http://doi.org/10.3348/kjr.2012.13.6.752

Abstract

OBJECTIVE
To evaluate the prognostic value of volume-based metabolic parameters measured with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) in patients with clinically node-negative (cN0) oral tongue squamous cell carcinoma (OTSCC) as compared with other prognostic factors.
MATERIALS AND METHODS
In this study, we included a total of 57 patients who had been diagnosed with cN0 tongue cancer by radiologic, 18F-FDG PET/CT, and physical examinations. The maximum standardized uptake value (SUVmax), average SUV (SUVavg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors were measured with 18F-FDG PET. The prognostic significances of these parameters and other clinical variables were assessed by Cox proportional hazards regression analysis.
RESULTS
In the univariate analysis, pathological node (pN) stage, American Joint Committee on Cancer (AJCC) stage, SUVmax, SUVavg, MTV, and TLG were significant predictors for survival. On a multivariate analysis, pN stage (hazard ratio = 10.555, p = 0.049), AJCC stage (hazard ratio = 13.220, p = 0.045), and MTV (hazard ratio = 2.698, p = 0.033) were significant prognostic factors in cN0 OTSCC patients. The patients with MTV > or = 7.78 cm3 showed a worse prognosis than those with MTV < 7.78 cm3 (p = 0.037).
CONCLUSION
The MTV of primary tumor as a volumetric parameter of 18F-FDG PET, in addition to pN stage and AJCC stage, is an independent prognostic factor for survival in cN0 OTSCC.

Keyword

18F-FDG PET/CT; Oral tongue squamous cell carcinoma; SUV; Metabolic tumor volume; Total lesion glycolysis; Prognosis prediction

MeSH Terms

Adult
Aged
Carcinoma, Squamous Cell/diagnosis/mortality/pathology/*radionuclide imaging
Female
Fluorodeoxyglucose F18/*diagnostic use
Humans
Lymphatic Metastasis
Magnetic Resonance Imaging
Male
Middle Aged
*Positron-Emission Tomography and Computed Tomography
Prognosis
Radiopharmaceuticals/*diagnostic use
Survival Rate
Tomography, X-Ray Computed
Tongue Neoplasms/diagnosis/mortality/pathology/*radionuclide imaging
Young Adult

Figure

• 

  Fig. 1 18F-FDG PET/CT images from 35-year-old male patient with squamous cell carcinoma of tongue. Primary tumor uptake is well visualized on MIP image (A). Segmented VOIs are shown on transverse (B), sagittal (C), coronal (D), and fused PET/CT (E) images. MIP = maximum-intensity-projection, VOI = volume of interest. 18F-FDG PET/CT = 18F-fluorodeoxyglucose positron emission tomography/CT

• 

  Fig. 2 Kaplan-Meier survival curve according to metabolic tumor volume of primary tumor in clinically node-negative oral tongue squamous cell carcinoma.

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