Background
This study aimed at assessing the prognostic value of textural indices extracted from 18F‐fluorodeoxyglucose positron‐emission tomography (FDG‐PET)/CT in a large cohort of patients with head and neck squamous cell carcinomas (HNSCC) of any anatomic subsite and staging.
Methods
Consecutive patients with HNSCC referred for a pretreatment FDG‐PET/CT were retrospectively included and followed up for a minimum of 2 years. Standardized uptake value, metabolic tumor volume (MTV), and textural indices were calculated using LIFEx software. Prognostic significance of parameters was assessed in univariate and multivariate analysis.
Results
Textural indices were extracted in 284 patients (mean age = 63.7±9.6 years). In univariate analysis, MTV and 4 textural indices—Correlation, Entropy, Energy, and Coarseness—were significantly correlated with overall survival (OS). In multivariate analysis, MTV (P = .008) and Correlation (P = .028) remained independently correlated to OS.
Conclusion
This study showed that MTV and 1 textural index extracted from pretherapeutic FDG‐PET/CT (Correlation) were independent prognostic factors of OS in patients with HNSCC.
Early therapeutic response demonstrated on FDG PET/CT after two cycles of induction chemotherapy with DCF in patients with inoperable stage III/IV HNSCC seems to be a predictive factor for EFS.
For PE diagnosis with lung SPECT, the use of ldCT in substitution to ventilation SPECT is associated with a high risk of overdiagnosis. The diagnostic value of ldCT in addition to V/Q SPECT remains unclear. Further studies are needed to determine its potential role in PE diagnosis.
The dense triangle sign on helical unenhanced brain CT has an excellent NPV to exclude a sinus thrombosis during the first 2 weeks. However, we believe that visual assessment of spontaneous hyperdensity is not sufficient for the diagnosis of CVT, with possible false-positive of the hSSS on unenhanced CT.
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