18F-fluoromisonidazole positron emission tomography before treatment is a predictor of radiotherapy outcome and survival prognosis in patients with head and neck squamous cell carcinoma
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To evaluate the usefulness of [18F]fluoromisonidazole ([18F]FMISO)-positron emission tomography (PET) prior to the treatment of head and neck squamous cell carcinoma.
Seventeen patients with untreated HNSCC underwent pretreatment [18F]FMISO PET. Six of them underwent definitive surgery and the remaining 11 definitive (chemo-)radiotherapy. We evaluated 30 lesions from the 17 patients. SUVmax and tumor-to-muscle ratios (TMR) were measured as hypoxia indicators. Tumors equal to or above the median value were defined as tumor with high uptake of [18F]FMISO and those below as tumor with low uptake of [18F]FMISO in both indicators. Local control rates with radiotherapy, event-free survival and disease-specific survival (DSS) rates with radiotherapy or operation were compared.
[18F]FMISO-PET imaging of 30 lesions resulted in a SUVmax median value of 2.3 and a TMR median value of 1.3. Local control rates with radiotherapy (20-month median follow-up duration) were significantly lower in the tumor group with high uptake of [18F]FMISO compared to the tumor group with low uptake of [18F]FMISO using either SUVmax or TMR as the hypoxic indicator (P = 0.02 and 0.04, respectively). DSS rate with radiotherapy or operation (21-month median follow-up duration) was significantly lower in the patient group with high uptake of [18F]FMISO compared to the patient group with low uptake of [18F]FMISO defined by SUVmax (P = 0.04), but was not by TMR (P = 0.57).
Radiotherapy outcome and survival prognosis (radiotherapy or operation) in HNSCC may be predicted by carrying out [18F]FMISO PET before treatment.
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- 18F-fluoromisonidazole positron emission tomography before treatment is a predictor of radiotherapy outcome and survival prognosis in patients with head and neck squamous cell carcinoma
Annals of Nuclear Medicine
Volume 25, Issue 9 , pp 625-633
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- [18F]fluoromisonidazole ([18F]FMISO)
- Positron emission tomography (PET)
- Head and neck cancer
- Prediction of prognosis
- Industry Sectors
- Author Affiliations
- 1. Department of Otolaryngology, Head and Neck Surgery, Kobe City Medical Center General Hospital, 4-6 Minatojima-Nakamachi, Chuo-ku, Kobe, 650-0046, Japan
- 2. Division of Molecular Imaging, Institute of Biomedical Research and Innovation, Kobe, Japan
- 3. Department of Otolaryngology, Shizuoka General Hospital, Shizuoka, Japan