Prognostic significance of standardized uptake value on 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography in patients with nasopharyngeal carcinoma

Abstract

The aim of this study was to investigate the prognostic significance of standardized uptake value (SUV) on 18 fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in patients with nasopharyngeal carcinoma (NPC). Thirty-four patients who have histologically proven NPC and underwent 18F-FDG PET/CT were included in this study. After 18F-FDG PET/CT, all the patients received radiation therapy and 32 of them received concomitant weekly chemotherapy. The maximum SUV (SUVmax) at the primary tumor and the SUVmaxof the highest neck nodes were determined. The SUVmax-T ranged from 5.00 to 30.80 (mean: 15.37 ± 6.10) and there was no difference between SUVmax-T values for early and late stages (P = 0.99). The SUVmax-N ranged from 3.10 to 23.80 (mean: 13.23 ± 5.76). There was no correlation between SUVmax-T and SUVmax-N (r = 0.111, P = 0.532). There was no difference between the SUVmax-T and the positivity of neck lymph nodes (P = 0.169). The ability of SUVmaks-N to predict stage was obtained by a receiver operating characteristic (ROC) analysis. The area under the curve is 0.856 and the best cut-off value is 7.88. There was a good correlation between SUVmax-N and stage. While the mean SUVmax-T for the alive patients was slightly lower than that for the dead (14.65 ± 5.58 vs. 20.30 ± 7.92, P = 0.061), the difference between the groups was not statistically significant. Furthermore, there was no statistically significant difference for SUVmax-N between these two groups (P: 0.494). Cox-regression analysis showed that an increase in SUVmax-T and SUVmax-N was associated with death risk (relative risk [RR]: 1.13, P = 0.078 and RR: 1.052, P = 0.456, respectively). SUVmax-T and SUVmax-N were independent prognostic factors for survival in NPC patients. This will help the clinicians in choosing suitable candidates for more aggressive treatment modalities.

Pivotal role of PET/CT in characterization of occult metastasis with undetermined origin

“…SUV value of more than 3 was considered significant as a reliable predictive value for predicting malignancy. This method of PET/CT SUVmax was selected as a relative minimum cut-off value for best optimal sensitivity and accuracy and was relied upon the average SUVmax results of the previous studies [14][15][16].…”

Prognostic value of baseline [18F]-fluorodeoxyglucose positron emission tomography parameters MTV, TLG and asphericity in an international multicenter cohort of nasopharyngeal carcinoma patients

“…Furthermore, another monocentric study from Turkey investigated the role of primary tumor and lymph node SUV max on the outcome of 32 patients. The authors observed a statistical trend towards worse survival for patients with higher SUV max of the primary tumor [36]. Unfortunately, both Turkish studies did not include further volumetric PET parameters like MTV or TLG.…”

[18F] FDG PET/CT and Head and Neck MRI in the Diagnosis and Prognosis of Moroccan Patients With Nasopharyngeal Carcinoma

“…This could be due to the short follow-up period. Several studies suggest that N-SUV max is more important than T-SUV max for prediction of DMFS in NPC patients(Lin et al 2016)(Türkölmez et al 2017;Jeong et al 2017). In another study, Chen et al reported that a high N-SUV max on pretreatment [ 18 F] FDG PET/CT (> 7.75) was an independent prognostic factor for worse DMFS in NPC patients(Chen et al 2015).…”

“…In another study, Chen et al reported that a high N-SUV max on pretreatment [ 18 F] FDG PET/CT (> 7.75) was an independent prognostic factor for worse DMFS in NPC patients(Chen et al 2015). Furthermore, Türkölmez et al demonstrated that high T-SUV max and N-SUV max were related to death risk(Türkölmez et al 2017). Similarly, our results reported that high N-SUV max (> 9.4) was signi cantly associated with poor OS and PFS, with HR of 0.7 (95% CI, 0.48-1.01; p = 0.05) and 0.52 (95% CI, 0.29-0.93; p = 0.02) for OS and PFS, respectively.…”