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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.01.2014 | Original Article

Predictive value of pre-therapy ¹⁸F-FDG PET/CT for the outcome of ¹⁸F-FDG PET-guided radiotherapy in patients with head and neck cancer

verfasst von: M. Picchio, M. Kirienko, P. Mapelli, I. Dell’Oca, E. Villa, F. Gallivanone, L. Gianolli, C. Messa, I. Castiglioni

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 1/2014

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Abstract

Purpose

The aim of this study was to evaluate the predictive role of pre-therapy fluorodeoxyglucose (FDG) uptake parameters of primary tumour in head and neck cancer (HNC) patients undergoing intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) on FDG-positive volume—positron emission tomography (PET) gross tumour volume (PET-GTV).

Methods

This retrospective study included 19 patients (15 men and 4 women, mean age 59.2 years, range 23–81 years) diagnosed with HNC between 2005 and 2011. Of 19 patients, 15 (79 %) had stage III–IV. All patients underwent FDG PET/CT before treatment. Metabolic indexes of primary tumour, including metabolic tumour volume (MTV), maximum and mean standardized uptake value (SUV_max, SUV_mean) and total lesion glycolysis (TLG) were considered. Partial volume effect correction (PVC) was performed for SUV_mean and TLG estimation. Correlations between PET/CT parameters and 2-year disease-free survival (DFS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) were assessed. Median patient follow-up was 19.2 months (range 4–24 months).

Results

MTV, TLG and PVC-TLG predicting patients’ outcome with respect to all the considered local and distant disease control endpoints (LRFS, DMFS and DFS) were 32.4 cc, 469.8 g and 547.3 g, respectively. SUV_mean and PVC-SUV_mean cut-off values predictive of LRFS and DFS were 10.8 and 13.3, respectively. PVC was able to compensate errors up to 25 % in the primary HNC tumour uptake. Moreover, PVC enhanced the statistical significance of the results.

Conclusion

FDG PET/CT uptake parameters are predictors of patients’ outcome and can potentially identify patients with higher risk of treatment failure that could benefit from more aggressive approaches. Application of PVC is recommended for accurate measurement of PET parameters.

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Titel: Predictive value of pre-therapy 18F-FDG PET/CT for the outcome of 18F-FDG PET-guided radiotherapy in patients with head and neck cancer
verfasst von: M. Picchio
M. Kirienko
P. Mapelli
I. Dell’Oca
E. Villa
F. Gallivanone
L. Gianolli
C. Messa
I. Castiglioni
Publikationsdatum: 01.01.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 1/2014
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2528-2

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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