18F-FDG PET/CT Metabolic Tumor Volume And Total Lesion Glycolysis Predict Outcome In Oropharyngeal Squamous Cell Carcinoma
Remy Lim, Anne Eaton, Nancy Y. Lee, Jeremy S Setton, Nisha Ohri, Shyam Rao, Richard J Wong, Matthew G. Fury, Heiko Schöder
Published 2012 · Medicine
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Treatment of oropharyngeal squamous cell carcinoma with chemoradiotherapy can now accomplish excellent locoregional disease control, but patient overall survival (OS) remains limited by development of distant metastases (DM). We investigated the prognostic value of staging 18F-FDG PET/CT, beyond clinical risk factors, for predicting DM and OS in 176 patients after definitive chemoradiotherapy. Methods: The PET parameters maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were recorded. Univariate Cox regression was used to examine the prognostic value of these variables and clinical prognosticators for local treatment failure (LTF), OS, and DM. Multivariate analysis examined the effect of SUVmax, TLG, and MTV in the presence of other covariates. Kaplan–Meier curves were used to evaluate prognostic values of PET/CT parameters. Results: Primary tumors were distributed across all stages. Most patients underwent chemoradiotherapy only, and 11 also underwent tonsillectomy. On univariate analysis, primary tumor MTV was predictive of LTF (P = 0.005, hazard ratio [HR] = 2.4 for a doubling of MTV), DM and OS (P < 0.001 for both, HR = 1.9 and 1.8, respectively). The primary tumor TLG was associated with DM and OS (P < 0.001, HR = 1.6 and 1.7, respectively, for a doubling of TLG). The primary tumor SUVmax was associated with death (P = 0.029, HR = 1.1 for a 1-unit increase in standardized uptake value) but had no relationship with LTF or DM. In multivariate analysis, TLG and MTV remained associated with death after correcting for T stage (P = 0.0125 and 0.0324, respectively) whereas no relationship was seen between standardized uptake value and death after adjusting for T stage (P = 0.158). Conclusion: Parameters capturing the volume of 18F-FDG–positive disease (MTV or TLG) provide important prognostic information in oropharyngeal squamous cell carcinoma treated with chemoradiotherapy and should be considered for risk stratification in this disease.
This paper references
[18F]Fluorodeoxyglucose Uptake in Tumors: Kinetic vs. Steady‐State Methods with Reference to Plasma Insulin
Heikki Minn (1993)
Metabolic Tumor Volume of [18F]-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Predicts Short-Term Outcome to Radiotherapy With or Without Chemotherapy in Pharyngeal Cancer
Man Ki Chung (2009)
Tumor volume as a prognostic factor in oropharyngeal squamous cell carcinoma treated with primary radiotherapy.
Mark J Been (2008)
Concordance Probability and Discriminatory Power in Proportional Hazards Regression
Mithat Gonen (2005)
Intensity-modulated radiotherapy in the treatment of oropharyngeal cancer: an update of the Memorial Sloan-Kettering Cancer Center experience.
Jeremy S Setton (2012)
Prediction of outcome in head-and-neck cancer patients using the standardized uptake value of 2-[18F]fluoro-2-deoxy-D-glucose.
Abdelkarim Said Allal (2004)
Tumor Volume Assessment by 18F-FDG PET/CT in Patients with Oral Cavity Cancer with Dental Artifacts on CT or MR Images
C H Baek (2008)
18F-fluorodeoxyglucose positron emission tomography to evaluate cervical node metastases in patients with head and neck squamous cell carcinoma: a meta-analysis.
Panayiotis A. Kyzas (2008)
Cervical lymph node metastasis.
Jatin P Shah (1993)
HPV-associated head and neck cancer: a virus-related cancer epidemic.
Shanthi Marur (2010)
The prognostic value of FDG PET in head and neck cancer. Correlation with histopathology.
Natascha Doebert (2005)
Simple imputation methods
R Little (2002)
Clinical outcomes of patients receiving integrated PET/CT-guided radiotherapy for head and neck carcinoma.
Matthew R. Vernon (2008)
Classification and regression trees (CART) used for the exploration of prognostic factors measured on different scales
Berthold Lausen (1994)
Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy: a 9-year, 337-patient, multi-institutional experience.
Bruce E. Brockstein (2004)
Metabolic tumor volume predicts for recurrence and death in head-and-neck cancer.
Trang H. La (2008)
FDG–PET. A possible prognostic factor in head and neck cancer
Wayne Halfpenny (2002)
Head and neck cancer: clinical usefulness and accuracy of PET/CT image fusion.
Heiko Schöder (2004)
Statistical Analysis with Missing Data
Roderick J. A. Little (1987)
FDG-PET prediction of head and neck squamous cell cancer outcomes.
David L. Schwartz (2004)
Tumor volume in pharyngolaryngeal squamous cell carcinoma: comparison at CT, MR imaging, and FDG PET and validation with surgical specimen.
Jean-François Daisne (2004)
Clinical features of pharyngeal cancer: a retrospective study of 258 consecutive patients.
Ana Escribano Uzcudun (2001)
Imaging-based nodal classification for evaluation of neck metastatic adenopathy.
Peter M. Som (2000)
Comparative Assessment of Methods for Estimating Tumor Volume and Standardized Uptake Value in 18F-FDG PET
Perrine Tylski (2010)
An iterative technique to segment PET lesions using a Monte Carlo based mathematical model.
Sadek Adnan Nehmeh (2009)
Segmentation of lung lesion volume by adaptive positron emission tomography image thresholding.
Yusuf E. Erdi (1997)
Cancer statistics, 2010.
Ahmedin Jemal (2010)
Changing Failure Patterns in Oropharyngeal Squamous Cell Carcinoma Treated With Intensity Modulated Radiotherapy and Implications for Future Research
Min Yao (2006)
Measurement of tumor volume by PET to evaluate prognosis in patients with head and neck cancer treated by chemo-radiation therapy
Young Mi Seol (2010)
Oral cavity and oropharynx tumors.
Hilda E. Stambuk (2007)
Oral cavity, oropharynx, and hypopharynx.
Minerva Becker (2000)
Diagnostic and Prognostic Value of [18F]Fluorodeoxyglucose Positron Emission Tomography for Recurrent Head and Neck Squamous Cell Carcinoma
Richard J Wong (2002)
FDGPET: a possible prognostic factor in head and neck cancer
W Halfpenny (2002)
Tumor Treatment Response Based on Visual and Quantitative Changes in Global Tumor Glycolysis Using PET-FDG Imaging. The Visual Response Score and the Change in Total Lesion Glycolysis.
Steven M. Larson (1999)
Patterns of cervical node metastases from squamous carcinoma of the oropharynx and hypopharynx.
Fabrizio Candela (1990)
Positron emission tomography for prostate, bladder, and renal cancer.
Heiko Schöder (2004)
Squamous cell carcinoma of the oropharynx: surgery, radiation therapy, or both.
James T. Parsons (2002)
This paper is referenced by
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 [(18)F] fluorodeoxyglucose positron emission tomography scan.
Paul B Romesser (2014)
Diagnostic Applications of Nuclear Medicine: Head and Neck Cancer
Heiko Schöder (2016)
Prognostic Value of SUVmean in Oropharyngeal and Hypopharyngeal Cancers: Comparison with SUVmax and Other Volumetric Parameters of 18F-FDG PET
Kyoungjune Pak (2015)
Volume-based parameters on FDG PET may predict the proliferative potential of soft-tissue sarcomas
Tomoka Kitao (2018)
Influence of volumetric 4′-[methyl-11C]-thiothymidine PET/CT parameters for prediction of the clinical outcome of head and neck cancer patients
Hiroshi Hoshikawa (2016)
Heterogeneity and irregularity of pretreatment 18F-fluorodeoxyglucose positron emission tomography improved prognostic stratification of p16-negative high-risk squamous cell carcinoma of the oropharynx.
Nai-Ming Cheng (2018)
Accuracy of metabolic volume and total glycolysis among six threshold-based target segmentation algorithms
Tetsu Nakaichi (2020)
Prognostic Value of Metabolic Tumor Volume and Total Lesion Glycolysis on Preoperative 18F-FDG PET/CT in Patients With Renal Cell Carcinoma
Reiko Nakajima (2017)
Pretreatment metabolic tumor volume as a prognostic factor in HPV‐associated oropharyngeal cancer in the context of AJCC 8th edition staging
John M Floberg (2018)
Role of 18F-FDG PET/CT in Posttreatment Evaluation of Anal Carcinoma
Clémence Houard (2017)
Prognostic value of FDG PET metabolic tumor volume in human papillomavirus-positive stage III and IV oropharyngeal squamous cell carcinoma.
Krishna C Alluri (2014)
Correlation of human papilloma virus status with quantitative perfusion/diffusion/metabolic imaging parameters in the oral cavity and oropharyngeal squamous cell carcinoma: comparison of primary tumour sites and metastatic lymph nodes.
Miran Han (2018)
PET Assessment of Immune Effects from Interventional Oncology Procedures.
Stephen J. Hunt (2019)
PET quantification with a histogram derived total activity metric: superior quantitative consistency compared to total lesion glycolysis with absolute or relative SUV thresholds in phantoms and lung cancer patients.
Irene A. Burger (2014)
Feasibility study of FDG PET/CT-derived primary tumour glycolysis as a prognostic indicator of survival in patients with non-small-cell lung cancer.
Geeta Mehta (2014)
Quantitative assessment of global hepatic glycolysis in patients with cirrhosis and normal controls using 18F-FDG-PET/CT: a pilot study
Ana Celia Hernández-Martínez (2013)
Hypoxia, blood flow and metabolism in squamous-cell carcinoma of the head and neck: correlations between multiple immunohistochemical parameters and PET
Tove J Grönroos (2014)
Metabolic Tumour Volume from PSMA PET/CT Scans of Prostate Cancer Patients during Chemotherapy—Do Different Software Solutions Deliver Comparable Results?
Philipp E Hartrampf (2020)
A review of the predictive role of functional imaging in patients with mucosal primary head and neck cancer treated with radiation therapy
Myo Min (2017)
18F-FDG-PET/CT parameters as imaging biomarkers in oral cavity squamous cell carcinoma, is visual analysis of PET and contrast enhanced CT better than the numbers?
Ayse Tuba Karagulle Kendi (2015)
Assessment of metabolic patterns and new antitumoral treatment in osteosarcoma xenograft models by [18F]FDG and sodium [18F]fluoride PET
María Collantes (2018)
FDG PET/CT Imaging of Oropharyngeal Squamous Cell Carcinoma: Characteristics of Human Papillomavirus–Positive and –Negative Tumors
Abdel Kader Tahari (2014)
CT-based volumetric tumor growth velocity: A novel imaging prognostic indicator in oropharyngeal cancer patients receiving radiotherapy.
Subha Perni (2016)
Interaction of quantitative (18)F-FDG-PET-CT imaging parameters and human papillomavirus status in oropharyngeal squamous cell carcinoma.
Charlotte S. Schouten (2016)
Impact of total lesion glycolysis measured by 18F-FDG-PET/CT on overall survival and distant metastasis in hypopharyngeal cancer.
Hidenori Suzuki (2016)
Prognostic value of FDG-PET volumetric parameters in patients with p16-positive oropharyngeal squamous cell carcinoma who received curative resection followed by postoperative radiotherapy or chemoradiotherapy.
Kyung Hwan Kim (2016)
Zone-size nonuniformity of 18F-FDG PET regional textural features predicts survival in patients with oropharyngeal cancer
Nai-Ming Cheng (2014)
Volumetric parameters of 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography can predict histopathologic treatment response after neoadjuvant chemoradiotherapy in pancreatic adenocarcinoma.
Makoto Sakane (2017)
Prognostic value of pretreatment 18F-FDG PET/CT parameters including visual evaluation in patients with head and neck squamous cell carcinoma.
Sho Koyasu (2014)
FDG PET/CT in Crohn’s disease: correlation of quantitative FDG PET/CT parameters with clinical and endoscopic surrogate markers of disease activity
Babak Saboury (2013)
Deregulation of glycolysis in cancer: glyceraldehyde-3-phosphate dehydrogenase as a therapeutic target
George S. Krasnov (2013)
The role of metabolic tumor volume and total lesion glycolysis on 18F-FDG PET/CT in the prognosis of epithelial ovarian cancer
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