Standardized Uptake Value of 2-[¹⁸F] Fluoro-2-Deoxy-d-Glucose in Predicting Outcome in Head and Neck Carcinomas Treated by Radiotherapy With or Without Chemotherapy

Abstract

S t a n d a r d i z e d U p t a k e V a l u e o f 2 -[ 1 8 F ] F l u o r o -2 -D e o x y -D -G l u c o s e i n P r e d i c t i n g O u t c o m e i n H e a d a n d N e c k C a r c i n o m a s T r e a t e d b y R a d i o t h e r a p y W i t h o r W i t h o u t C h e m o t h e r a p yPatients and Methods: We studied 63 patients with carcinomas of the head and neck who had an FDG-PET scan before radical RT. Tumor FDG uptake was measured with the semiquantitative standardized uptake value (SUV). All patients but one were treated with accelerated or hyperfractionated RT schedules. Thirteen patients received concomitant cisplatin-based chemotherapy.Results: In 25 patients who presented with any component of treatment failure, the SUV was significantly higher than in the remaining patients without any such failure. Patients having tumors with high FDG uptake had a significantly lower 3-year local control (55% v 86%, P ‫؍‬ .01) and DFS (42% v 79%, P ‫؍‬ .005) compared with patients having low uptake tumors. In the multivariate analysis, the only factor that retained its significance for DFS was SUV category, whereas T category was of borderline significance. For local control, T category remained a significant factor, whereas a lower local control was observed for tumors with a high SUV compared with those with low SUV.Conclusion: FDG uptake, as measured by the SUV, has potential value in predicting local control and DFS in head and neck carcinomas treated by RT. High FDG uptake may be a useful parameter for identifying patients requiring more aggressive treatment approaches.

Prognostic Value of Metabolic Activity Measured by 18F-FDG PET/CT in Patients with Advanced Endometrial Cancer

“…In addition to providing information about diagnosis and staging, FDG PET/CT is used to predict clinical outcome [18]. The prognostic value of FDG PET/CT has been previously reported in several types of malignancies [6][7][8]19]. Up to now, the clinical use of FDG PET/CT has been established in gynecological malignancies such as cervical, ovarian, and vulvar cancer.…”

“…Tumor glucose metabolism measured by FDG PET has been reported to be valuable in predicting the outcome of many cancers, such as head and neck squamous cell carcinoma [6][7][8], lymphoma [9][10][11], and esophageal [12] and lung cancers [13]. However, studies on the prognostic value of FDG PET in endometrial cancer are limited.…”

Overview of the predictive value of quantitative 18 FDG PET in head and neck cancer treated with chemoradiotherapy

“…Thanks to its ease of use, it was historically the first parameter analyzed. SUVmax was correlated with overall-or disease free survival in 11 studies (Allal et al, 2002;Brun et al, 2002;Castaldi et al, 2012;Chen et al, 2014;Farrag et al, 2010;Higgins et al, 2012;Kitagawa et al, 2003;Machtay et al, 2009;Matoba et al, 2015;Rasmussen et al, 2015;Sanghera et al, 2005). SUVmax allows to identify patients with a high risk of events (death or recurrence).…”

“…The authors developed a prognostic model of freedom from failure at 2 years, in which including SUVmax significantly increased the predictive value, changing the estimated risk by more than 10% for 23% of the patients. In (Allal et al, 2002), 63 patients treated with RT ± CT were prospectively included. Patients presenting a SUVMax <5.5 g/ml had a 3-year DFS of 79% compared to 42% for those with SUVmax > 5.5 g/ml (p = 0.005).…”

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

“…These essentially include tumor size, the stage of tumor at presentation, extent of lymph node involvement, extracapsular lymph node spread, surgical margin involvement and anatomic subsite. However, despite careful evaluation of these factors, it is not possible to reliably predict the outcome of treatment in individual patients [1,2].…”