Predictive value of quantitative diffusion-weighted imaging and 18-F-FDG-PET in head and neck squamous cell carcinoma treated by (chemo)radiotherapy

Abstract

Background and purpose: In head and neck squamous cell carcinoma (HNSCC) (chemo)radiotherapy is increasingly used to preserve organ functionality. The purpose of this study was to identify predictive pretreatment DWI-and 18 F-FDG-PET/CT-parameters for treatment failure (TF), locoregional recurrence (LR) and death in HNSCC patients treated by (chemo)radiotherapy. Materials and methods: We retrospectively included 134 histologically proven HNSCC patients treated with (chemo)radiotherapy between 2012-2017. In 58 patients pre-treatment DWI and 18 F-FDG-PET/CT were performed, in 31 patients DWI only and in 45 patients 18 F-FDG-PET/CT only. Primary tumor (PT) and largest lymph node (LN) metastasis were quantitatively assessed for TF, LR and death. Multivariate analysis was performed for 18 F-FDG-PET/CT and DWI separately and thereafter combined. In patients with both imaging modalities, positive and negative predictive value in TF and differences in LR and death, were assessed. Results: Mean follow-up was 25.6 months (interquartile-range; 14.0-37.1 months). Predictors of treatment failure, corrected for TNM-stage and HPV-status, were SUV max-PT , ADC max-PT , total lesion glycolysis (TLG-LN), ADCp20-LN (P = 0.049, P = 0.024, P = 0.031, P = 0.047, respectively). TLG-PT was predictive for LR (P = 0.003). Metabolic active tumor volume (MATV-PT) (P = 0.003), ADC GTV-PT (P < 0.001), ADCSD (P = 0.048) were significant predictors for death. In patients with both imaging modalities SUV max-PT remained predictive for treatment failure (P = 0.049), TLG-LN for LR (P = 0.003) and ADC GTV-PT for death (P < 0.001). Higher predictive value for treatment failure was found for the combination of SUV max-PT and ADC max-PT , compared to either one separately. Conclusion: Both DWI-and 18 F-FDG-PET/CT-parameters appear to have predictive value for treatment failure, locoregional recurrence and death. Combining SUV max-PT and ADC max-PT resulted in better prediction of treatment failure compared to single parameter assessment.

C-11 methionine PET and 18-F FDG-PET for identifying recurrent laryngeal carcinoma

“…DW-MRI has shown promising results in staging nodal metastasis, the detection of recurrent disease and the assessment of tumor response and prognosis after chemo-radiotherapy for HNSCC. The sensitivity and specificity rates obtained are more or less similar to those obtained with [ 18 F]-FDG-PET [56][57][58][59][60][61][62][63][64][65][66] . unfortunately, the majority of these studies contain too few patients and included different sites.…”

Initial and Delayed Metabolic Activity of Palatine Tonsils Measured with the PET/CT-Dedicated Parameters

“…According to the literature [ 9 ], the SUVmax value exceeding 2.50 may suggest abnormality within the ROI. In terms of PTs, the SUVmax value at the level 2.50 indicates most often the physiologic glucose metabolism level.…”

“…of the 18 F-FDG [ 5 , 6 ], authors [ 7 , 8 ] reported the possibility to perform the sequential DTP imaging as more convenient and easier to perform for differential diagnosis purposes. Moreover, evaluating various metabolic parameters and their surrogates using different scanning protocols might improve the diagnostic accuracy of the 18 F-FDG PET/CT method in H&N cancer patients [ 9 , 10 , 11 ].…”

Predictive Value of Diffusion, Glucose Metabolism Parameters of PET/MR in Patients With Head and Neck Squamous Cell Carcinoma Treated With Chemoradiotherapy

“…According to the results using this method, ADC could be an indicator of locoregional failure, which is a component of the treatment response. The ADC mean values (ADC mean ) are, therefore, possible parameters for prediction, per the suggestion of Martens et al ( 16 ). Leifels et al found that tumor metabolism, cellularity, and perfusion show complex relationships in HNSCC.…”