The role of changes in maximum standardized uptake value of FDG PET-CT for post-treatment surveillance in patients with head and neck squamous cell carcinoma treated with chemoradiotherapy: preliminary findings

Matoba, Munetaka; Tuji, Hiroyuki; Shimode, Yuzo; Tamaki, Kunihiko; Oota, Kiyotaka; Tonami, Hisao

doi:10.1259/bjr.20150404

Cited by 7 publications

(10 citation statements)

References 29 publications

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“…Support for the findings of our study can be drawn from the study by Matoba[16] et al who analyzed both pre- and post-therapy PET CT in 40 head and neck cancer patients undergoing chemoradiation and found the posttherapy SUVmax value at 3 months’ posttherapy to be a stronger indicator of relapse and progressive disease than the pretreatment value. In addition, Kikuchi et al [17] in their study on nasopharyngeal cancer patients undergoing neoadjuvant chemotherapy also showed that a reduction in posttherapy SUVmax (>50%) predicted better outcome while Hentschel et al [18] showed similar findings in head and neck cancer patients on chemoradiation who underwent serial weekly PET CT during the first 2 weeks of therapy.…”

Section: Discussionsupporting

confidence: 82%

The prognostic role of maximum standardized uptake value of 18 F-flourodeoxy glucose positron emission tomography-computed tomography in head and neck cancer patients undergoing chemoradiotherapy

Srinivas

Arunan

Venkatachalapathy

et al. 2019

J Int Soc Prevent Communit Dent

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Aims and Objectives: This retrospective study aims at correlating the pre- and post-therapy maximal standardized uptake values (SUV max ) of the whole-body 18-flourodeoxy glucose positron emission tomography (FDG-PET) scan with tumor response in patients with head and neck squamous cell cancer undergoing chemoradiotherapy. Materials and Methods: Data for this retrospective study were taken from the clinical records of 20 evaluable head and neck cancer patients who had availed treatment and evaluation at our institute during the previous year (March 2017–April 2018). All these above-mentioned patients had undergone chemoradiation at our center for locally advanced squamous cell carcinoma of the head and neck and had undergone pre- and post-therapy whole-body FDG PET scan. The posttherapy PET-computed tomography (CT) was advised after 8 weeks’ postcompletion of therapy. During the PET CT scan, images were acquired 1 h after injection of FDG. Pre- and post-therapy SUV max were recorded and correlated with immediate treatment response. Results: The mean pretherapy SUV Max of the primary tumor was 10.27 ranging from 4.5 to 26.17. The mean pretherapy SUV Max of the node was 5.34 ranging from 0 to 17.9. The mean time of recording the posttherapy SUV Max was 3 months (range 2–5 months). The mean posttherapy SUV Max of the primary tumor was 1.05 ranging from complete metabolic response to 6.4. The mean posttherapy SUV Max of the node was 0.7 ranging from complete metabolic response to 5.43. The statistical analysis based on Wilcoxon–Signed Rank test revealed a statistically significant difference in the pre- and post-therapy SUV max values for both primary tumor ( P < 0.001) and regional node ( P = 0.001). Majority of patients ( n = 15) showed clinical remission; however, five patients had progressive disease at the time of evaluation. Conclusion: Although the retrospective study revealed that complete responders had a statistically significant reduction in the posttherapy SUV max in comparison to the pretherapy SUV max it failed to identify a cutoff value for pretherapy SUV max which could predict the probable outcome of therapy. In view of the same further prospective studies need to be conducted with larger patient numbers including various other tumor metabolic markers for greater clarity.

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Section: Discussionsupporting

confidence: 82%

The prognostic role of maximum standardized uptake value of 18 F-flourodeoxy glucose positron emission tomography-computed tomography in head and neck cancer patients undergoing chemoradiotherapy

Srinivas

Arunan

Venkatachalapathy

et al. 2019

J Int Soc Prevent Communit Dent

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“…Only 3 of the 25 studies [ 31 , 32 , 40 ] provided information about tobacco exposure in terms of pack-years. Generic information on subjects with a smoking history was reported in six additional studies [ 22 , 28 – 30 , 39 , 43 ] (81.4%, 82.6%, 67.3%, 80%, 90.9% and 72% of patients were current or former smokers, respectively). In addition, data on baseline ECOG Performance Status were reported for only 29% of the whole cohort (646/2,223).…”

Section: Resultsmentioning

confidence: 99%

What is the prognostic impact of FDG PET in locally advanced head and neck squamous cell carcinoma treated with concomitant chemo-radiotherapy? A systematic review and meta-analysis

Bonomo

Merlotti

Olmetto

et al. 2018

Eur J Nucl Med Mol Imaging

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PurposeEvidence is conflicting on the prognostic value of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in head and neck squamous cell carcinoma. The aim of our study was to determine the impact of semiquantitative and qualitative metabolic parameters on the outcome in patients managed with standard treatment for locally advanced disease.MethodsA systematic review of the literature was conducted. A meta-analysis was performed of studies providing estimates of relative risk (RR) for the association between semiquantitative metabolic parameters and efficacy outcome measures.ResultsThe analysis included 25 studies, for a total of 2,223 subjects. The most frequent primary tumour site was the oropharynx (1,150/2,223 patients, 51.7%). According to the available data, the majority of patients had stage III/IV disease (1,709/1,799, 94.9%; no information available in four studies) and were treated with standard concurrent chemoradiotherapy (1,562/2,009 patients, 77.7%; only one study without available information). A total of 11, 8 and 4 independent studies provided RR estimates for the association between baseline FDG PET metrics and overall survival (OS), progression-free survival (PFS) and locoregional control (LRC), respectively. High pretreatment metabolic tumour volume (MTV) was significantly associated with a worse OS (summary RR 1.86, 95% CI 1.08–3.21), PFS (summary RR 1.81, 95% CI 1.14–2.89) and LRC (summary RR 3.49, 95% CI 1.65–7.35). Given the large heterogeneity (I2 > 50%) affecting the summary measures, no cumulative threshold for an unfavourable prognosis could be defined. No statistically significant association was found between SUVmax and any of the outcome measures.ConclusionFDG PET has prognostic relevance in the context of locally advanced head and neck squamous cell carcinoma. Pretreatment MTV is the only metabolic variable with a significant impact on patient outcome. Because of the heterogeneity and the lack of standardized methodology, no definitive conclusions on optimal cut-off values can be drawn.Electronic supplementary materialThe online version of this article (10.1007/s00259-018-4065-5) contains supplementary material, which is available to authorized users.

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“…Metabolic imaging with 18 F-FDG PET-CT has evolved as a tool for the post-treatment evaluation of HNSCC but is generally delayed for at least 12 weeks due to the potential for falsepositive resulting from early post-treatment inflammatory changes (Mehanna et al 2016). Although qualitative interpretative criteria are most frequently applied (Koksel et al 2019;Krabbe et al 2009;Marcus et al 2014;Porceddu et al 2011;Sjövall et al 2016;Zhong et al 2020), quantitative analysis of SUV max with 18 F-FDG PET-CT has been shown to have prognostic significance (Moeller et al 2009;Chan et al 2012;Sherriff et al 2012;Castelli et al 2016;Kim et al 2016;Matoba et al 2017) and multi-objective (Zhang et al2018). However, we were unable to demonstrate the value of 12-week post-CRT SUV max in predicting DFS in our predominantly HPV-OPC cohort.…”

Section: Discussionmentioning

confidence: 99%

“…Metabolic imaging with 18F-fluorodeoxygluocose ( 18 F-FDG) PET-CT (Sheikhbahaei et al 2015) may overcome these limitations and is widely used to achieve earlier detection of residual disease. Quantitative post-treatment 18 F-FDG PET-CT SUV max (Moeller et al 2009;Chan et al 2012;Sherriff et al 2012;Castelli et al 2016;Kim et al 2016;Matoba et al 2017) has been shown to predict treatment failure and survival outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…HPV OPC has unique histopathological characteristics (Chernock et al 2009) and differing tumour metabolism (Krupar 2014) which influence ADC measures (Chan et al 2016;Driessen et al 2016) and post-treatment SUV max (Moeller et al 2009;Zhang et al 2010;Castelli et al 2016;Vainshtein et al 2014;Helsen et al 2018), whilst resulting in improved clinical outcomes (Chaturvedi et al 2011). However, the HPV-OPC status is rarely documented in studies of post-treatment quantitative DW-MRI (Marzi et al 2017) or post-treatment 18 F-FDG PET-CT in predicting HNSCC outcomes (Sherriff et al 2012;Kim et al 2016;Matoba et al 2017). HPV OPC has not been previously considered as a co-variant in the studies of post-treatment ADC values and their prognostic significance in HNSCC.…”

Section: Introductionmentioning

confidence: 99%

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The ability of post-chemoradiotherapy DWI ADCmean and 18F-FDG SUVmax to predict treatment outcomes in head and neck cancer: impact of human papilloma virus oropharyngeal cancer status

Connor

Sit

Anjari

et al. 2021

J Cancer Res Clin Oncol

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Objectives To evaluate the ability of post-chemo-radiotherapy (CRT) diffusion-weighted-MRI apparent diffusion coefficient (ADCmean) and 18F-FDG PET maximum standardized uptake value (SUVmax) to predict disease-free survival (DFS) in head and neck squamous cell carcinoma (HNSCC), and to determine whether this ability is influenced by human papillomavirus oropharyngeal cancer (HPV-OPC) status. Methods This prospective cohort observational study included 65 participants (53 male, mean ± SD age 59.9 ± 7.9 years, 46 HPV-OPC) with stage III or IV HNSCC. Primary tumour and nodal ADCmean (pre-treatment, 6- and 12-weeks post-CRT) and SUVmax (12-weeks post-CRT) were measured. Variables were compared with 2-year DFS (independent t-test/Mann–Whitney test) and overall DFS (Cox regression), before and after accounting for HPV-OPC status. Variables were also compared between HPV-OPC and other HNSCC subgroups after stratifying for DFS. Results Absolute post-CRT ADCmean values predicted 2-year DFS and overall DFS for all participants (p = 0.03/0.03, 6-week node; p = 0.02/0.03 12-week primary tumour) but not in the HPV-OPC subgroup. In participants with DFS, percentage interval changes in primary tumour ADCmean at 6- and 12-weeks were higher in HPV-OPC than other HNSCC (p = 0.01, 6 weeks; p = 0.005, 12 weeks). The 12-week post-CRT SUVmax did not predict DFS. Conclusion Absolute post-CRT ADCmean values predicted DFS in HNSCC but not in the HPV-OPC subgroup. Amongst participants with DFS, post-CRT percentage interval changes in primary tumour ADCmean were significantly higher in HPV-OPC than in other HNSCC. Knowledge of HPV-OPC status is crucial to the clinical utilisation of post-CRT DWI-MRI for the prediction of outcomes.

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The role of changes in maximum standardized uptake value of FDG PET-CT for post-treatment surveillance in patients with head and neck squamous cell carcinoma treated with chemoradiotherapy: preliminary findings

Abstract: The ΔSUV of the primary tumour showed a significant association with recurrence and patient survival. Advances in knowledge: The ΔSUV of the primary tumour may be a valid clinical parameter to help decision-making for the surveillance management of patients with HNSCC after CRT.

Cited by 7 publications

References 29 publications

The prognostic role of maximum standardized uptake value of 18 F-flourodeoxy glucose positron emission tomography-computed tomography in head and neck cancer patients undergoing chemoradiotherapy

The prognostic role of maximum standardized uptake value of 18 F-flourodeoxy glucose positron emission tomography-computed tomography in head and neck cancer patients undergoing chemoradiotherapy

What is the prognostic impact of FDG PET in locally advanced head and neck squamous cell carcinoma treated with concomitant chemo-radiotherapy? A systematic review and meta-analysis

The ability of post-chemoradiotherapy DWI ADCmean and 18F-FDG SUVmax to predict treatment outcomes in head and neck cancer: impact of human papilloma virus oropharyngeal cancer status

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