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Prognostic significance of standardized uptake value and metabolic tumour volume on 18F-FDG PET/CT in oropharyngeal squamous cell carcinoma

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Abstract

Purpose

Standardized uptake value (SUV) and metabolic tumour volume (MTV) measured by 18F-FDG PET/CT are emerging prognostic biomarkers in human solid cancers. However, their prognostic significance in oropharyngeal squamous cell carcinoma (OPSCC) has been investigated in only a few studies and with small cohorts. In the present study we evaluated the ability of SUV, MTV, and total lesion glycolysis (TLG) measured on pretreatment 18F-FDG PET/CT to predict recurrence and survival outcomes in OPSCC.

Methods

The study included 221 patients with OPSCC who underwent pretreatment 18F-FDG PET/CT imaging and received definitive treatment at our tertiary referral centre. The PET imaging parameters SUVmax, SUVpeak, MTV and TLG were measured in primary tumours with focal 18F-FDG uptake. Clinical and imaging variables significantly associated with overall survival (OS) and disease-free survival (DFS) were identified by univariate and multivariate analyses using the Cox proportional hazards model.

Results

Overall 5-year OS and DFS rates were 72.0 % and 79.5 %, respectively, during a median follow-up of 61 months (range 18 – 122 months). The cut-off values of tumour SUVmax, SUVpeak, MTV and TLG for prediction of DFS were 7.55, 6.80, 11.06 mL and 78.56 g, respectively. Univariate analyses showed that age >60 years, advanced tumour stage, and high tumour SUVmax, SUVpeak, MTV and TLG were significantly associated with decreased OS and DFS (P < 0.05 each). Age, tumour SUVmax and MTV remained independent variables for OS and DFS (P < 0.05 each) in the multivariate analyses.

Conclusion

SUVmax and MTV measured on pretreatment 18F-FDG PET/CT may be useful in predicting the clinical outcomes in OPSCC patients.

Condensed abstract

This study investigated the clinical prognostic value of imaging parameters from pretreatment 18F-FDG PET/CT in 221 patients who underwent definitive treatment for oropharyngeal squamous cell carcinoma. High maximum standardized uptake value and metabolic tumour volume were independently associated with decreased disease-free and overall survival outcomes.

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Compliance with ethical standards

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Conflicts of interest

None.

Funding

This study was supported by a grant (no. 2014–0306) from the Asan Institute for Life Science and a grant (HI14C23050000) from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Seoul, Republic of Korea, Seoul, Korea (J.-L. Roh).

Statement of human rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of retrospective study, formal consent is not required.

Statement on the welfare of animals

This article does not describe any studies with animals performed by any of the authors.

Informed consent

For this type of retrospective study, informed consent from each patient was waived.

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Author notes

    Authors and Affiliations

    1. Department of Otolaryngology, Asan Medical Centre, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea

      Ji Won Kim, Jong-Lyel Roh, Seung-Ho Choi, Soon Yuhl Nam & Sang Yoon Kim

    2. Department of Nuclear Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea

      Jungsu S. Oh & Jae Seung Kim

    3. Korea Institute of Science and Technology, Biomedical Research Institute, Seoul, Republic of Korea

      Sang Yoon Kim

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    1. Ji Won Kim
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    Correspondence to Jong-Lyel Roh.

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    Ji Won Kim and Jungsu S. Oh contributed equally to this work.

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    Kim, J.W., Oh, J.S., Roh, JL. et al. Prognostic significance of standardized uptake value and metabolic tumour volume on 18F-FDG PET/CT in oropharyngeal squamous cell carcinoma. Eur J Nucl Med Mol Imaging 42, 1353–1361 (2015). https://doi.org/10.1007/s00259-015-3051-4

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