Prognostic value of 99mTc-HYNIC Annexin-V imaging in squamous cell carcinoma of the head and neck



The purpose of the study was to report on the prognostic value of 99mTc-hydrazinonicotinamide (HYNIC) Annexin-V single-photon emission computed tomography (SPECT) imaging in patients suffering from primary squamous cell carcinoma of the head and neck.


Twenty-nine patients diagnosed with a primary untreated head and neck squamous cell carcinoma were included in this study. In all patients, 99mTc-HYNIC Annexin-V scintigraphy SPECT was performed before treatment instigation. Tumour-to-background ratios (T/N) of the primary tumour, derived from reconstructed images, as well as clinical variables were obtained in all patients and related to patient outcome. Median follow-up was 22.6 months (range 4.1–55.8 months).


On univariate as well as multivariate analysis, only the 99mTc-HYNIC Annexin-V T/N ratio dichotomized using the group median as cutoff value (T/N ratio of 2) was predictive of recurrence-free survival (respectively, p = 0.0000 and 0.000). On univariate analysis, only lymph node status dichotomized according to N0 vs N1–N2–N3 disease and the 99mTc-HYNIC Annexin-V T/N ratio dichotomized using the group median as cutoff value (T/N ratio of 2) were predictive of overall survival (p = 0.0051 and 0.0000). When both factors were included in the multivariate model, both N status and the 99mTc-HYNIC Annexin-V T/N ratio showed an independent association with overall survival (p = 0.001 for lymph node status and 0.000 for dichotomized 99mTc-HYNIC Annexin-V T/N ratio).


99mTc-HYNIC Annexin-V T/N ratios derived from SPECT provides independent prognostic information on disease-free survival and overall survival.

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Correspondence to Christophe Van de Wiele.

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Loose, D., Vermeersch, H., De Vos, F. et al. Prognostic value of 99mTc-HYNIC Annexin-V imaging in squamous cell carcinoma of the head and neck. Eur J Nucl Med Mol Imaging 35, 47–52 (2008) doi:10.1007/s00259-007-0577-0

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  • Annexin V
  • Apoptosis imaging
  • Molecular imaging
  • Oncology
  • Prognosis