Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 9/2015

01-08-2015 | Original Article

Prognostic significance of standardized uptake value and metabolic tumour volume on 18F-FDG PET/CT in oropharyngeal squamous cell carcinoma

Authors: Ji Won Kim, Jungsu S. Oh, Jong-Lyel Roh, Jae Seung Kim, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2015

Login to get access

Abstract

Purpose

Standardized uptake value (SUV) and metabolic tumour volume (MTV) measured by 18F-FDG PET/CT are emerging prognostic biomarkers in human solid cancers. However, their prognostic significance in oropharyngeal squamous cell carcinoma (OPSCC) has been investigated in only a few studies and with small cohorts. In the present study we evaluated the ability of SUV, MTV, and total lesion glycolysis (TLG) measured on pretreatment 18F-FDG PET/CT to predict recurrence and survival outcomes in OPSCC.

Methods

The study included 221 patients with OPSCC who underwent pretreatment 18F-FDG PET/CT imaging and received definitive treatment at our tertiary referral centre. The PET imaging parameters SUVmax, SUVpeak, MTV and TLG were measured in primary tumours with focal 18F-FDG uptake. Clinical and imaging variables significantly associated with overall survival (OS) and disease-free survival (DFS) were identified by univariate and multivariate analyses using the Cox proportional hazards model.

Results

Overall 5-year OS and DFS rates were 72.0 % and 79.5 %, respectively, during a median follow-up of 61 months (range 18 – 122 months). The cut-off values of tumour SUVmax, SUVpeak, MTV and TLG for prediction of DFS were 7.55, 6.80, 11.06 mL and 78.56 g, respectively. Univariate analyses showed that age >60 years, advanced tumour stage, and high tumour SUVmax, SUVpeak, MTV and TLG were significantly associated with decreased OS and DFS (P < 0.05 each). Age, tumour SUVmax and MTV remained independent variables for OS and DFS (P < 0.05 each) in the multivariate analyses.

Conclusion

SUVmax and MTV measured on pretreatment 18F-FDG PET/CT may be useful in predicting the clinical outcomes in OPSCC patients.

Condensed abstract

This study investigated the clinical prognostic value of imaging parameters from pretreatment 18F-FDG PET/CT in 221 patients who underwent definitive treatment for oropharyngeal squamous cell carcinoma. High maximum standardized uptake value and metabolic tumour volume were independently associated with decreased disease-free and overall survival outcomes.
Literature
1.
Sturgis EM, Cinciripini PM. Trends in head and neck cancer incidence in relation to smoking prevalence: an emerging epidemic of human papillomavirus-associated cancers? Cancer. 2007;110(7):1429–35.PubMedCrossRef
2.
3.
4.
Setton J, Caria N, Romanyshyn J, Koutcher L, Wolden SL, Zelefsky MJ, et al. Intensity-modulated radiotherapy in the treatment of oropharyngeal cancer: an update of the Memorial Sloan-Kettering Cancer Center experience. Int J Radiat Oncol Biol Phys. 2012;82(1):291–8.PubMedCrossRef
5.
Huang K, Xia P, Chuang C, Weinberg V, Glastonbury CM, Eisele DW, et al. Intensity-modulated chemoradiation for treatment of stage III and IV oropharyngeal carcinoma: the University of California–San Francisco experience. Cancer. 2008;113(3):497–507.PubMedCrossRef
6.
Rischin D. Oropharyngeal cancer, human papilloma virus, and clinical trials. J Clin Oncol. 2010;28(1):1–3.PubMedCrossRef
7.
Patel SG, Lydiatt WM. Staging of head and neck cancers: is it time to change the balance between the ideal and the practical? J Surg Oncol. 2008;97(8):653–7.PubMedCrossRef
8.
Takes RP, Rinaldo A, Silver CE, Piccirillo JF, Haigentz Jr M, Suárez C, et al. Future of the TNM classification and staging system in head and neck cancer. Head Neck. 2010;32(12):1693–711.PubMedCrossRef
9.
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC cancer staging manual. 7th ed. New York, NY: Springer; 2010. p. 41–56.
10.
Antoch G, Saoudi N, Kuehl H, Dahmen G, Mueller SP, Beyer T, et al. Accuracy of whole-body dual-modality fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography (FDG-PET/CT) for tumor staging in solid tumors: comparison with CT and PET. J Clin Oncol. 2004;22(21):4357–68.PubMedCrossRef
11.
Lonneux M, Hamoir M, Reychler H, Haingon P, Duvillard C, Calais G, et al. Positron emission tomography with [18F]-fluorodeoxyglucose improves staging and patient management in patients with head and neck squamous cell carcinoma: a multicenter prospective study. J Clin Oncol. 2010;28(7):1190–5.PubMedCrossRef
12.
Schöder H, Fury M, Lee N, Kraus D. PET monitoring of therapy response in head and neck squamous cell carcinoma. J Nucl Med. 2009;50:74S–88S.PubMedCrossRef
13.
Moeller BJ, Rana V, Cannon BA, Williams MD, Sturgis EM, Ginsberg LE, et al. Prospective risk-adjusted [18F]fluorodeoxyglucose positron emission tomography and computed tomography assessment of radiation response in head and neck cancer. J Clin Oncol. 2009;27(15):2509–15.PubMedCentralPubMedCrossRef
14.
Allal AS, Slosman DO, Kebdani T, Allaoua M, Lehmann W, Dulguerov P. Prediction of outcome in head-and-neck cancer patients using the standardized uptake value of 2-[18F]fluoro-2-deoxy-D-glucose. Int J Radiat Oncol Biol Phys. 2004;59(5):1295–300.PubMedCrossRef
15.
Liao CT, Wang HM, Huang SF, Chen IH, Kang CJ, Lin CY, et al. PET and PET/CT of the neck lymph nodes improves risk prediction in patients with squamous cell carcinoma of the oral cavity. J Nucl Med. 2011;52(2):180–7.PubMedCrossRef
16.
Kim SY, Roh JL, Kim MR, Kim JS, Choi SH, Nam SY, et al. Use of 18F-FDG PET for primary treatment strategy in patients with squamous cell carcinoma of the oropharynx. J Nucl Med. 2007;48(5):752–7.PubMedCrossRef
17.
Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009;50 Suppl 1:122S–50S.PubMedCentralPubMedCrossRef
18.
Chung MK, Jeong HS, Park SG, Jang JY, Son YI, Choi JY, et al. Metabolic tumor volume of [18F]-fluorodeoxyglucose positron emission tomography/computed tomography predicts short-term outcome to radiotherapy with or without chemotherapy in pharyngeal cancer. Clin Cancer Res. 2009;15(18):5861–8.PubMedCrossRef
19.
Chen HH, Chiu NT, Su WC, Guo HR, Lee BF. Prognostic value of whole-body total lesion glycolysis at pretreatment FDG PET/CT in non-small cell lung cancer. Radiology. 2012;264(2):559–66.PubMedCrossRef
20.
Dibble EH, Alvarez AC, Truong MT, Mercier G, Cook EF, Subramaniam RM. 18F-FDG metabolic tumor volume and total glycolytic activity of oral cavity and oropharyngeal squamous cell cancer: adding value to clinical staging. J Nucl Med. 2012;53(5):709–15.PubMedCrossRef
21.
Park GC, Kim JS, Roh JL, Choi SH, Nam SY, Kim SY. Prognostic value of metabolic tumor volume measured by 18F-FDG PET/CT in advanced-stage squamous cell carcinoma of the larynx and hypopharynx. Ann Oncol. 2013;24(1):208–14.PubMedCrossRef
22.
Romesser PB, Lim R, Spratt DE, Setton J, Riaz N, Lok B, et al. The relative prognostic utility of standardized uptake value, gross tumor volume, and metabolic tumor volume in oropharyngeal cancer patients treated with platinum based concurrent chemoradiation with a pre-treatment [18F]fluorodeoxyglucose positron emission tomography scan. Oral Oncol. 2014;50(9):802–8.PubMedCrossRef
23.
Kikuchi M, Koyasu S, Shinohara S, Usami Y, Imai Y, Hino M, et al. Prognostic value of pretreatment 18F-fluorodeoxyglucose positron emission tomography/CT volume-based parameters in patients with oropharyngeal squamous cell carcinoma with known p16 and p53 status. Head Neck. 2014. doi:10.​1002/​hed.​23784.
24.
Lasnon C, Desmonts C, Quak E, Gervais R, Do P, Dubos-Arvis C, et al. Harmonizing SUVs in multicentre trials using different generation PET systems: prospective validation in non-small cell lung cancer patients. Eur J Nucl Med Mol Imaging. 2013;40(7):985–96.PubMedCentralPubMedCrossRef
25.
Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, et al. FDG PET and PET/CT: EANM procedure guidelines for tumor PET imaging: version 1.0. Eur J Nucl Med Mol Imaging. 2010;37(1):181–200.PubMedCentralPubMedCrossRef
26.
27.
Oh JS, Oh M, Chung SJ, Kim JS. Cerebellum-specific 18F-FDG PET analysis for the detection of subregional glucose metabolism changes in spinocerebellar ataxia. Neuroreport. 2014;25(15):1198–202.PubMedCrossRef
28.
Williams BA, Mandrekar JN, Mandrekar SJ, Cha SS, Furth AF. Finding optimal cutpoints for continuous covariates with binary and time-to-event outcomes. Rochester, MN: Department of Health Sciences Research Mayo Clinic; 2006.
29.
Halfpenny W, Hain SF, Biassoni L, Maisey MN, Sherman JA, McGurk M. FDG-PET. A possible prognostic factor in head and neck cancer. Br J Cancer. 2002;86(4):512–6.PubMedCentralPubMedCrossRef
30.
Wong RJ, Lin DT, Schöder H, Patel SG, Gonen M, Wolden S, et al. Diagnostic and prognostic value of [18F]-fluorodeoxyglucose positron emission tomography for recurrent head and neck squamous cell carcinoma. J Clin Oncol. 2002;20(20):4199–208.PubMedCrossRef
31.
Lin SC, Liao CY, Kao CH, Yen KY, Yang SN, Wang YC, et al. Pretreatment maximal standardized uptake value of the primary tumor predicts outcome to radiotherapy in patients with pharyngeal cancer. J Radiat Res. 2012;53(3):462–8.PubMedCrossRef
32.
Joo YH, Yoo IR, Cho KJ, Park JO, Nam IC, Kim MS. Preoperative 18F-FDG PET/CT and high-risk HPV in patients with oropharyngeal squamous cell carcinoma. Head Neck. 2014;36(3):323–7.PubMedCrossRef
33.
Lim R, Eaton A, Lee NY, Setton J, Ohri N, Rao S, et al. 18F-FDG PET/CT metabolic tumor volume and total lesion glycolysis predict outcome in oropharyngeal squamous cell carcinoma. J Nucl Med. 2012;53(10):1506–13.PubMedCrossRef
34.
Paidpally V, Chirindel A, Lam S, Agrawal N, Quon H, Subramaniam RM. FDG-PET/CT imaging biomarkers in head and neck squamous cell carcinoma. Imaging Med. 2012;4(6):633–47.PubMedCentralPubMedCrossRef
35.
Chen SW, Hsieh TC, Yen KY, Liang JA, Kao CH. Pretreatment (18)F-FDG PET/CT in whole-body total lesion glycolysis to predict survival in patients with pharyngeal cancer treated with definitive radiotherapy. Clin Nucl Med. 2014;39(5):e296–300.PubMedCrossRef
36.
Moon SH, Choi JY, Lee HJ, Son YI, Baek CH, Ahn YC, et al. Prognostic value of 18F-FDG PET/CT in patients with squamous cell carcinoma of the tonsil: comparison of volume-based metabolic parameters. Head Neck. 2013;35(1):15–22.PubMedCrossRef
Metadata
Title
Prognostic significance of standardized uptake value and metabolic tumour volume on 18F-FDG PET/CT in oropharyngeal squamous cell carcinoma
Authors
Ji Won Kim
Jungsu S. Oh
Jong-Lyel Roh
Jae Seung Kim
Seung-Ho Choi
Soon Yuhl Nam
Sang Yoon Kim
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2015
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-015-3051-4

Other articles of this Issue 9/2015

European Journal of Nuclear Medicine and Molecular Imaging 9/2015 Go to the issue

Image of the Month

68Ga-PSMA imaging of metastatic breast cancer

Original Article

Aortic 18F-FDG uptake in patients suffering from granulomatosis with polyangiitis

Review Article

Sentinel lymph node biopsy in oral and oropharyngeal squamous cell carcinoma: current status and unresolved challenges

Original Article

Quantifying [18F]fluorodeoxyglucose uptake in the arterial wall: the effects of dual time-point imaging and partial volume effect correction

Original Article

111In-anti-F4/80-A3-1 antibody: a novel tracer to image macrophages

Editorial

Adding variables to complexity. Molecular imaging and molecular biology: a no-longer-secret liaison in NETs