Analysis of Pretreatment FDG-PET SUV Parameters in Head-and-Neck Cancer: Tumor SUV{sub mean} Has Superior Prognostic Value
- Department of Radiology, Division of Neuroradiology, Duke University Medical Center, Durham, NC (United States)
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC (United States)
- Department of Radiology, Division of Nuclear Medicine, Duke University Medical Center, Durham, NC (United States)
Purpose: To evaluate the prognostic significance of different descriptive parameters in head-and-neck cancer patients undergoing pretreatment [F-18] fluoro-D-glucose-positron emission tomography (FDG-PET) imaging. Patients and Methods: Head-and-neck cancer patients who underwent FDG-PET before a course of curative intent radiotherapy were retrospectively analyzed. FDG-PET imaging parameters included maximum (SUV{sub max}), and mean (SUV{sub mean}) standard uptake values, and total lesion glycolysis (TLG). Tumors and lymph nodes were defined on co-registered axial computed tomography (CT) slices. SUV{sub max} and SUV{sub mean} were measured within these anatomic regions. The relationships between pretreatment SUV{sub max}, SUV{sub mean}, and TLG for the primary site and lymph nodes were assessed using a univariate analysis for disease-free survival (DFS), locoregional control (LRC), and distant metastasis-free survival (DMFS). Kaplan-Meier survival curves were generated and compared via the log-rank method. SUV data were analyzed as continuous variables. Results: A total of 88 patients was assessed. Two-year OS, LRC, DMFS, and DFS for the entire cohort were 85%, 78%, 81%, and 70%, respectively. Median SUV{sub max} for the primary tumor and lymph nodes was 15.4 and 12.2, respectively. Median SUV{sub mean} for the primary tumor and lymph nodes was 7 and 5.2, respectively. Median TLG was 770. Increasing pretreatment SUV{sub mean} of the primary tumor was associated with decreased disease-free survival (p = 0.01). Neither SUV{sub max} in the primary tumor or lymph nodes nor TLG was prognostic for any of the clinical endpoints. Patients with pretreatment tumor SUV{sub mean} that exceeded the median value (7) of the cohort demonstrated inferior 2-year DFS relative to patients with SUV{sub mean} {<=} the median value of the cohort, 58% vs. 82%, respectively, p = 0.03. Conclusion: Increasing SUV{sub mean} in the primary tumor was associated with inferior DFS. Although not routinely reported, pretreatment SUV{sub mean} may be a useful prognostic FDG-PET parameter and should be further evaluated prospectively.
- OSTI ID:
- 22055993
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 82, Issue 2; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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