[Fluorine-18]Fluorodeoxyglucose Positron Emission Tomography, DNA Ploidy and Growth Fraction in Squamous-Cell Carcinomas of the Head and Neck

Abstract

Background: Positron emission tomography (PET) offers an opportunity to examine noninvasively cellular functions with different tracers. [¹⁸F]Fluorodeoxyglucose (FDG) is most commonly used in identifying malignant tumors. Several tumor biologic characteristics (tumor cell viability, growth faction, treatment response to radiation, cell membrane dysfunction, recurrence rate) are suggested to be characterized by [¹⁸F]FDG PET. The aim of this study was to assess which other tumor biologic characteristics of squamous-cell carcinoma of the head and neck are correlated with [¹⁸F]FDG PET. Methods: [¹⁸F]FDG PET was performed in 14 patients with squamous-cell carcinomas of the upper digestive tract (TNM classification T₂–T₄, N₁–N₃). After attenuation correction, predefined areas of the tumor were semiquantitatively analyzed by the technique of the region of interest and calculated as standard uptake values (SUV). Afterwards, 5 biopsies of different tumor regions were obtained during endoscopy in each patient under general anesthesia, and a correlation between SUV of [¹⁸F]FDG PET and tumor biologic parameters was attempted. These parameters included: quantitative DNA measurements (i.e. 2c deviation index, 5c exceeding rate), immunohistochemical assessment of growth fraction (i.e. Ki67-MIB-1, PCNA) along with morphological tumor front grading. Results: The results revealed a marked variation of proliferation and cellular differentiation in various regions of the tumor for all parameters examined. There was a close correlation between [¹⁸F]FDG uptake and growth fraction (r = 0.83 for Ki67-MIB-1 and r = 0.8 for PCNA). A poor correlation was found between DNA aneuploidy (r = 0.4) or tumor front grading (r = 0.12) and [¹⁸F]FDG uptake. Conclusions: Our results confirm previous clinical and histologic observations that squamous-cell carcinomas of the upper digestive tract are heterogeneous tumors. Ki67 antigen, which has been shown to be of predictive value for proliferation and individual prognosis, correlated with [¹⁸F]FDG uptake. Using [¹⁸F]FDG PET, the main proliferation centers of inhomogeneous squamous-cell carcinomas could be identified with possible clinical implications for patient management.

p12CDK2-AP1 Gene Therapy Strategy Inhibits Tumor Growth in an In vivo Mouse Model of Head and Neck Cancer

“…Having observed a marked reduction in tumor size and growth rate, we assayed for the presence of the Ki-67 molecular marker, and following immunohistochemical analysis, the number of positive cells in all treatment groups was quantified at 400Â magnification. This proliferation marker is expressed in the G 1 -S-G 2 phases of the cell cycle and is commonly expressed in tumors and associated with progression or poor prognosis (36,37). p12 therapy caused a decrease in the fraction of cells expressing the proliferation marker Ki-67 (Fig.…”

Prognostic Value of Metabolic Tumor Volume Measured by 18F-FDG PET/CT in Locally Advanced Head and Neck Squamous Cell Carcinomas Treated by Surgery

“…Due to its biologic feature, FDG uptakes correlate with cell viability and proliferative activities [3][4][5]. In the past, a few authors have suggested that the degree of FDG uptake quantified as maximum standardized uptake value (SUV max ) is an independent factor predicting clinical outcome after treatment in HNSCC.…”

Effects of Intratumoral Inflammatory Process on 18F-FDG Uptake: Pathologic and Comparative Study with 18F-Fluoro-α-Methyltyrosine PET/CT in Oral Squamous Cell Carcinoma

“…To address this, the amino acid-based PET radiotracer 18 F-fluoro-a-methyltyrosine ( 18 F-FAMT), which accumulates exclusively in malignant tumor cells through the L-type amino acid transporter 1, was developed (10)(11)(12). In previous OSCC studies, 18 F-FAMT was better than 18 F-FDG in its correlation with tumor proliferation activity, represented by Ki-67 labeling index (Ki-67 LI) (13,14). Moreover, significant false-positive accumulation of 18 F-FDG in inflammatory lesions, other nonmalignant lesions, and some normal organs due to physiologic activity contributes to the lower specificity of 18 F-FDG for malignancy.…”