Predictive value of SUV-based parameters derived from pre-treatment (18)F-FLT PET/CT for short-term outcome with head and neck cancers.

Abstract

The aim of this study was to investigate the predictive potential of pre-treatment 3'-deoxy-3'-[18F]-fluorothymidine (FLT) uptake parameters for short-term outcome of primary head and neck squamous cell cancer (HNSCC) patients. A total of 32 patients undergoing pre-treatment FLT positron emission tomography/computed tomography (PET/CT) from May 2010 to May 2013 were evaluated. Semi-quantitative assessment was used to determine mean, peak and maximum standardized uptake values (SUVmean, SUVpeak and SUVmax), metabolic tumor volume (MTV) and total lesion proliferation (TLP). Clinicopathologic factors and PET/CT parameters were analyzed for their association with 2-year loco-regional control (LRC) and overall survival (OS). The mean (±SD) SUVmean, SUVpeak, SUVmax, MTV and TLP were 5.97±3.16, 6.71±3.75, 10.05±5.37, 7.31±8.05 and 44.95±52.82, respectively. In univariate analyses, N category was associated with OS (P=0.037). Increased MTV ≥13ml was associated with decreased LRC and OS (P<0.0001). TLP ≥69.3g was also linked with both LRC and OS (P=0.009 and 0.015, respectively). Regarding SUVs, only the SUVpeak was associated with LRC and OS (P=0.035 and 0.049, respectively). Pre-treatment MTV is the most useful parameter with FLT PET/CT. TLP and SUVpeak may also provide important prognostic information for patients with HNSCCs.