Nucl Med Mol Imaging.
2011 Mar;45(1):43-51.
Prognostic Value of Metabolic Tumor Volume Measured by 18F-FDG PET/CT in Locally Advanced Head and Neck Squamous Cell Carcinomas Treated by Surgery
- Affiliations
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- 1Department of Radiology, The Catholic University of Korea, Seoul, Korea.
- 2Department of Radiation Oncology, The Catholic University of Korea, Seoul, Korea.
- 3Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, Seoul, Korea.
- 4Department of Hospital Pathology, The Catholic University of Korea, Seoul, Korea.
- 5Department of Nuclear Medicine, Seoul St.Mary's Hospital, The Catholic University of Korea, Seochogu Banpodong 505, Seoul 137-701, Korea. iryoo@catholic.ac.kr
Abstract
- PURPOSE
We assessed the prognostic value of metabolic tumor volume (MTV) measured using 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) inpatients with locally advanced head and neck squamous cell carcinoma (HNSCC).
METHODS
We retrospectively reviewed 56 patients (51 men, five women; mean age 56.0+/-8.8years) who had locally advanced HNSCC and underwent FDG PET/CT for initial evaluation. All patients had surgical resection and radiotherapy with or without concurrent chemotherapy. The peak standardized uptake value (SUVpeak) and MTV of the target lesion, including primary HNSCC and metastatic cervical lymph nodes, were measured from FDG PET/CT images. We compared SUVpeak, MTV, and clinicopathologic variables such as age, Eastern Cooperative Oncology Group (ECOG) performance status, pN stage, pT stage, TNM stage, histologic grade and treatment modality to disease-free survival (DFS) and overall survival (OS).
RESULTS
On the initial FDG PET/CT scans, the median SUVpeak was 7.8 (range, 1.8-19.0) and MTV was 17.0 cm3 (range, 0.1-131.0 cm3). The estimated 2-year DFS and OS rates were 67.2% and 81.8%. The cutoff points of SUVpeak 6.2 and MTV 20.7 cm3 were the best discriminative values for predicting clinical outcome. MTV and ECOG performance status were significantly related to DFS and OS on univariate and multivariate analyses (p<0.05).
CONCLUSION
The MTV obtained from initial FDG PET/CT scan is a significant prognostic factor for disease recurrence and mortality in locally advanced HNSCC treated with surgery and radiotherapy with or without chemotherapy.
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