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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

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Abstract

Objective

To evaluate the usefulness of [18F]fluoromisonidazole ([18F]FMISO)-positron emission tomography (PET) prior to the treatment of head and neck squamous cell carcinoma.

Methods

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.

Result

[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).

Conclusions

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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Acknowledgments

This study was financially supported by Kasahara Fund for the promotion of cancer research.

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Authors and 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

    Masahiro Kikuchi, Shogo Shinohara, Keizo Fujiwara, Hiroshi Yamazaki & Yasushi Naito

  2. Division of Molecular Imaging, Institute of Biomedical Research and Innovation, Kobe, Japan

    Tomohiko Yamane & Michio Senda

  3. Department of Otolaryngology, Shizuoka General Hospital, Shizuoka, Japan

    Shin-ya Hori & Yosuke Tona

Authors
  1. Masahiro Kikuchi
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  2. Tomohiko Yamane
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  3. Shogo Shinohara
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  4. Keizo Fujiwara
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  5. Shin-ya Hori
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  6. Yosuke Tona
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  7. Hiroshi Yamazaki
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  8. Yasushi Naito
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  9. Michio Senda
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Correspondence to Masahiro Kikuchi.

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Kikuchi, M., Yamane, T., Shinohara, S. et al. 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. Ann Nucl Med 25, 625–633 (2011). https://doi.org/10.1007/s12149-011-0508-9

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  • DOI: https://doi.org/10.1007/s12149-011-0508-9

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