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Annals of Nuclear Medicine
Published in: Annals of Nuclear Medicine 7/2012

Open Access 01-08-2012 | Original article

Superior prognostic utility of gross and metabolic tumor volume compared to standardized uptake value using PET/CT in head and neck squamous cell carcinoma patients treated with intensity-modulated radiotherapy

Authors: Paul B. Romesser, Muhammad M. Qureshi, Bhartesh A. Shah, Luke T. Chatburn, Scharukh Jalisi, Anand K. Devaiah, Rathan M. Subramaniam, Minh Tam Truong

Published in: Annals of Nuclear Medicine | Issue 7/2012

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Abstract

Objective

To compare the prognostic utility of the 2-[18F] fluoro-2-deoxy-d-glucose (FDG) maximum standardized uptake value (SUVmax), primary gross tumor volume (GTV), and FDG metabolic tumor volume (MTV) for disease control and survival in patients with head and neck squamous cell carcinoma (HNSCC) undergoing intensity-modulated radiotherapy (IMRT).

Methods

Between 2007 and 2011, 41 HNSCC patients who underwent a staging positron emission tomography with computed tomography and definitive IMRT were identified. Local (LC), nodal (NC), distant (DC), and overall (OC) control, overall survival (OS), and disease-free survival (DFS) were assessed using the Kaplan–Meier product-limit method.

Results

With a median follow-up of 24.2 months (range 2.7–56.3 months) local, nodal, and distant recurrences were recorded in 10, 5, and 7 patients, respectively. The median SUVmax, GTV, and MTV were 15.8, 22.2 cc, and 7.2 cc, respectively. SUVmax did not correlate with LC (p = 0.229) and OS (p = 0.661) when analyzed by median threshold. Patients with smaller GTVs (<22.2 cc) demonstrated improved 2-year actuarial LC rates of 100 versus 56.4 % (p = 0.001) and OS rates of 94.4 versus 65.9 % (p = 0.045). Similarly, a smaller MTV (<7.2 cc) correlated with improved 2-year actuarial LC rates of 100 versus 54.2 % (p < 0.001) and OS rates of 94.7 versus 64.2 % (p = 0.04). Smaller GTV and MTV correlated with improved NC, DC, OC, and DFS, as well.

Conclusion

GTV and MTV demonstrate superior prognostic utility as compared to SUVmax, with larger tumor volumes correlating with inferior local control and overall survival in HNSCC patients treated with definitive IMRT.
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Metadata
Title
Superior prognostic utility of gross and metabolic tumor volume compared to standardized uptake value using PET/CT in head and neck squamous cell carcinoma patients treated with intensity-modulated radiotherapy
Authors
Paul B. Romesser
Muhammad M. Qureshi
Bhartesh A. Shah
Luke T. Chatburn
Scharukh Jalisi
Anand K. Devaiah
Rathan M. Subramaniam
Minh Tam Truong
Publication date
01-08-2012
Publisher
Springer Japan
Published in
Annals of Nuclear Medicine / Issue 7/2012
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-012-0604-5

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