The prognostic role of maximum standardized uptake value of 18 F-flourodeoxy glucose positron emission tomography-computed tomography in head and neck cancer patients undergoing chemoradiotherapy

Abstract

Aims and Objectives: This retrospective study aims at correlating the pre- and post-therapy maximal standardized uptake values (SUV max ) of the whole-body 18-flourodeoxy glucose positron emission tomography (FDG-PET) scan with tumor response in patients with head and neck squamous cell cancer undergoing chemoradiotherapy. Materials and Methods: Data for this retrospective study were taken from the clinical records of 20 evaluable head and neck cancer patients who had availed treatment and evaluation at our institute during the previous year (March 2017–April 2018). All these above-mentioned patients had undergone chemoradiation at our center for locally advanced squamous cell carcinoma of the head and neck and had undergone pre- and post-therapy whole-body FDG PET scan. The posttherapy PET-computed tomography (CT) was advised after 8 weeks’ postcompletion of therapy. During the PET CT scan, images were acquired 1 h after injection of FDG. Pre- and post-therapy SUV max were recorded and correlated with immediate treatment response. Results: The mean pretherapy SUV Max of the primary tumor was 10.27 ranging from 4.5 to 26.17. The mean pretherapy SUV Max of the node was 5.34 ranging from 0 to 17.9. The mean time of recording the posttherapy SUV Max was 3 months (range 2–5 months). The mean posttherapy SUV Max of the primary tumor was 1.05 ranging from complete metabolic response to 6.4. The mean posttherapy SUV Max of the node was 0.7 ranging from complete metabolic response to 5.43. The statistical analysis based on Wilcoxon–Signed Rank test revealed a statistically significant difference in the pre- and post-therapy SUV max values for both primary tumor ( P < 0.001) and regional node ( P = 0.001). Majority of patients ( n = 15) showed clinical remission; however, five patients had progressive disease at the time of evaluation. Conclusion: Although the retrospective study revealed that complete responders had a statistically significant reduction in the posttherapy SUV max in comparison to the pretherapy SUV max it failed to identify a cutoff value for pretherapy SUV max which could predict the probable outcome of therapy. In view of the same further prospective studies need to be conducted with larger patient numbers including various other tumor metabolic markers for greater clarity.

Prognostic significance of metabolic tumour volume and maximum standard uptake value of fluor-18-fluorodeoxyglucose positron emission tomography with computed tomography in nasopharyngeal carcinoma

“…In an earlier retrospective study on locally advanced head and neck cancer patients from India Srinivas et al . [ 20 ] failed to identify a cut-off value for pretherapy SUV max that could predict the probable outcome of therapy.…”

“…In contrast, in this study, the SUV max-P cut-off of 13.55 did not have any major bearing on the response rates or long-term survival outcomes, but the SUV max-N had a bearing on the outcomes. In an earlier retrospective study on locally advanced head and neck cancer patients from India Srinivas et al [20] failed to identify a cut-off value for pretherapy SUV max that could predict the probable outcome of therapy.…”

Clinical significance of recombinant RANBP2-ALK oncogene to radiotherapy in a case of locally advanced rectal epithelioid inflammatory myofibroblastic sarcoma: case report and review of literature

“…Of note, none of the previously reported cases had documented RANBP2-ALK fusion. The high SUVmax (Figure 3) value on repeat examination is indicative of high glucose transporter-1 expression, which is also indicative of poor prognosis and radioresistance among a variety of malignancies (10)(11)(12)(13). Failure to accurately delineate the treatment volume is unlikely as the pre-treatment 18 F-FDG PET-CT has been employed in the treatment planning.…”

Oligometastases in head and neck carcinoma and their impact on management

“…PET-CT is considered as the gold standard in detecting distant metastatic disease and may also detect second primary cancers in the lung or bowel. 77 Goel et al highlighted that PET-CT has a high sensitivity (92%) and specificity (95%) for the detection of distant metastasis in patients with suspected recurrent HNSCC. 78 Chen et al demonstrated the use of PET-CT in detecting involved retropharyngeal nodes in cases of NPC.…”

“…PET‐CT is considered as the gold standard in detecting distant metastatic disease and may also detect second primary cancers in the lung or bowel 77 . Goel et al .…”