Analysis of Pretreatment FDG-PET SUV Parameters in Head-and-Neck Cancer: Tumor SUV_mean Has Superior Prognostic Value

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• 作者：Kristin A. Higgins ; M.D.^&lowast ; ; ^{kristin.higgins@duke.edu} ; Jenny K. Hoang ; M.B.B.S.^&dagger ; ; Michael C. Roach ; B.E.^&lowast ; ; Junzo Chino ; M.D.^&lowast ; ; David S. Yoo ; M.D. ; Ph.D.^&lowast ; ; Timothy G. Turkington ; Ph.D.^&Dagger ; ; ^§ ; ; ^?/sup> ; David M. Brizel ; M.D.^&lowast ; ; ^¶ ;
• 关键词：Head and neck cancer ; FDG-PET ; SUVmean
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2012
• 出版时间：1 February 2012
• 年：2012
• 卷：82
• 期：2
• 页码：548-553
• 全文大小：192 K

文摘

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Purpose

To evaluate the prognostic significance of different descriptive parameters in head-and-neck cancer patients undergoing pretreatment [F-18] fluoro-D-glucose-positron emission tomography (FDG-PET) imaging.

Patients and Methods

Head-and-neck cancer patients who underwent FDG-PET before a course of curative intent radiotherapy were retrospectively analyzed. FDG-PET imaging parameters included maximum (SUV_max), and mean (SUV_mean) standard uptake values, and total lesion glycolysis (TLG). Tumors and lymph nodes were defined on co-registered axial computed tomography (CT) slices. SUV_max and SUV_mean were measured within these anatomic regions. The relationships between pretreatment SUV_max, SUV_mean, and TLG for the primary site and lymph nodes were assessed using a univariate analysis for disease-free survival (DFS), locoregional control (LRC), and distant metastasis-free survival (DMFS). Kaplan-Meier survival curves were generated and compared via the log?rank method. SUV data were analyzed as continuous variables.

Results

A total of 88 patients was assessed. Two-year OS, LRC, DMFS, and DFS for the entire cohort were 85 % , 78 % , 81 % , and 70 % , respectively. Median SUV_max for the primary tumor and lymph nodes was 15.4 and 12.2, respectively. Median SUV_mean for the primary tumor and lymph nodes was 7 and 5.2, respectively. Median TLG was 770. Increasing pretreatment SUV_mean of the primary tumor was associated with decreased disease-free survival (m>pm> = 0.01). Neither SUV_max in the primary tumor or lymph nodes nor TLG was prognostic for any of the clinical endpoints. Patients with pretreatment tumor SUV_mean that exceeded the median value (7) of the cohort demonstrated inferior 2-year DFS relative to patients with SUV_mean ?the median value of the cohort, 58 % vs. 82 % , respectively, m>pm> = 0.03.

Conclusion

Increasing SUV_mean in the primary tumor was associated with inferior DFS. Although not routinely reported, pretreatment SUV_mean may be a useful prognostic FDG-PET parameter and should be further evaluated prospectively.