Journal of Medical Imaging and Radiation Oncology

Volume 60, Issue 3 pp. 433-440

Radiation Oncology—Original Article

18F-FDG PET–CT performed before and during radiation therapy of head and neck squamous cell carcinoma: Are they independent or complementary to each other?

Myo Min,

Corresponding Author

Myo Min

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

University of New South Wales, Liverpool, New South Wales, Australia

Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia

Correspondence

Dr. Allan Fowler and Dr. Myo Min, Department of Radiation Oncology, Liverpool Hospital, Liverpool, NSW, 2170, Australia.

Emails: [email protected] and [email protected]

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Peter Lin,

Peter Lin

University of New South Wales, Liverpool, New South Wales, Australia

Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, New South Wales, Australia

University of Western Sydney, Liverpool, New South Wales, Australia

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Mark Lee,

Mark Lee

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

University of New South Wales, Liverpool, New South Wales, Australia

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Ivan Ho Shon,

Ivan Ho Shon

University of New South Wales, Liverpool, New South Wales, Australia

Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, New South Wales, Australia

University of Western Sydney, Liverpool, New South Wales, Australia

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Michael Lin,

Michael Lin

University of New South Wales, Liverpool, New South Wales, Australia

Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, New South Wales, Australia

University of Western Sydney, Liverpool, New South Wales, Australia

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Dion Forstner,

Dion Forstner

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

University of New South Wales, Liverpool, New South Wales, Australia

Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia

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Minh Thi Tieu,

Minh Thi Tieu

Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia

University of Newcastle, Callaghan, New South Wales, Australia

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Andrew Chicco,

Andrew Chicco

Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, New South Wales, Australia

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Victoria Bray,

Victoria Bray

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

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Allan Fowler,

Corresponding Author

Allan Fowler

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

Correspondence

Dr. Allan Fowler and Dr. Myo Min, Department of Radiation Oncology, Liverpool Hospital, Liverpool, NSW, 2170, Australia.

Emails: [email protected] and [email protected]

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Myo Min,

Corresponding Author

Myo Min

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

University of New South Wales, Liverpool, New South Wales, Australia

Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia

Correspondence

Dr. Allan Fowler and Dr. Myo Min, Department of Radiation Oncology, Liverpool Hospital, Liverpool, NSW, 2170, Australia.

Emails: [email protected] and [email protected]

Search for more papers by this author

Peter Lin,

Peter Lin

University of New South Wales, Liverpool, New South Wales, Australia

Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, New South Wales, Australia

University of Western Sydney, Liverpool, New South Wales, Australia

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Mark Lee,

Mark Lee

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

University of New South Wales, Liverpool, New South Wales, Australia

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Ivan Ho Shon,

Ivan Ho Shon

University of New South Wales, Liverpool, New South Wales, Australia

Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, New South Wales, Australia

University of Western Sydney, Liverpool, New South Wales, Australia

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Michael Lin,

Michael Lin

University of New South Wales, Liverpool, New South Wales, Australia

Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, New South Wales, Australia

University of Western Sydney, Liverpool, New South Wales, Australia

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Dion Forstner,

Dion Forstner

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

University of New South Wales, Liverpool, New South Wales, Australia

Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia

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Minh Thi Tieu,

Minh Thi Tieu

Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia

University of Newcastle, Callaghan, New South Wales, Australia

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Andrew Chicco,

Andrew Chicco

Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, New South Wales, Australia

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Victoria Bray,

Victoria Bray

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

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Allan Fowler,

Corresponding Author

Allan Fowler

Cancer Therapy Centre, Liverpool Hospital, Liverpool, New South Wales, Australia

Correspondence

Dr. Allan Fowler and Dr. Myo Min, Department of Radiation Oncology, Liverpool Hospital, Liverpool, NSW, 2170, Australia.

Emails: [email protected] and [email protected]

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First published: 12 February 2016

https://doi.org/10.1111/1754-9485.12439

Citations: 19

M Min FRANZCR; P Lin FRACP, M Lee FRANZCR; IH Shon FRACP; M Lin FRCP FRACP, D Forstner FRANZCR; MT Tieu FRANZCR, A Chicco MMedRadPhys; V Bray FRACP, A Fowler FRANZCR

Conflict of interest: None.

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Abstract

Introduction

The aims of this study are to evaluate the prognostic value of metabolic parameters derived from ¹⁸F-FDG PET-CT performed before definitive radiation therapy (RT) (prePET) in patients with mucosal primary head and neck squamous cell carcinoma (MPHNSCC) and to assess the additive prognostic values of FDG PET-CT performed during RT (iPET).

Methods

One hundred patients with MPHNSCC treated with radical RT underwent staging prePET and iPET performed during the third week of treatment. The maximum standardized uptake value (SUV_max), metabolic tumour volume (MTV) and total lesional glycolysis (TLG) of primary tumour were analysed for both prePET and iPET, and results were correlated with loco-regional recurrence-free survival (LRFS), disease-free survival (DFS), metastatic failure-free survival (MFFS) and overall survival (OS), using Kaplan–Meier analysis. Optimal cut-offs (OC) for prePET and iPET were derived from Receiver Operating Characteristic curves. Patients with metabolic parameters above/below the individual OC of prePET as well as iPET (i.e. combined prePET and iPET (comPET)) were evaluated against their outcomes.

Results

Median age was 61 years (range 39–81), median follow-up of 20 months (range 4–70, mean 27), and AJCC 7th Edition clinical stage II, III and IV were 8, 24 and 68 patients respectively. Metabolic values below individual OC in comPET were found to be associated with statistically significant improvements (P < 0.05) in DFS, LRFS and OS. In addition, patients with SUV_max above the OC in comPET were associated with worse MFFS (P = 0.011) and confirmed on both univariate (P = 0.019) and multivariate analyses (P = 0.04).

Conclusion

Addition of iPET significantly improves the prognostic values of all three metabolic parameters and can potentially be used in future adaptive local and systemic therapy trials.

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Volume60, Issue3

June 2016

Pages 433-440

18F-FDG PET–CT performed before and during radiation therapy of head and neck squamous cell carcinoma: Are they independent or complementary to each other?

Abstract

Introduction

Methods

Results

Conclusion

References

Citing Literature

References

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18F-FDG PET–CT performed before and during radiation therapy of head and neck squamous cell carcinoma: Are they independent or complementary to each other?

Abstract

Introduction

Methods

Results

Conclusion

References

Citing Literature

References

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