Nuklearmedizin 2021; 60(02): 154
DOI: 10.1055/s-0041-1726761
WIS-Vortrag
Onkologie – Bildgebung

Whole-lesion SUVmax including lymph node metastases for the prediction of distant metastases from head and neck squamous cell carcinoma: first results of a multicenter evaluation

M Hajiyianni
1   Charite – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiation Oncology, Berlin
,
S Zschaeck
1   Charite – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiation Oncology, Berlin
,
J van den Hoff
2   Helmholtz-Zentrum Dresden-Rossendorf, Institut für Radiopharmazeutische Krebsforschung, Dresden
,
F Hofheinz
2   Helmholtz-Zentrum Dresden-Rossendorf, Institut für Radiopharmazeutische Krebsforschung, Dresden
› Author Affiliations
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Ziel/Aim FDG uptake metrics of the primary tumor (most commonly: SUV) bear only little or no prognostic value regarding development of distant metastases in patients with head and neck squamous cell carcinoma (HNSCC). However, the independent prognostic value of combining SUV quantification of primary tumour and lymph node metastases has yet to be investigated. The detection of patients at high risk for developing distant metastases would allow a personalized approach by selecting the right candidates for intensified or alternative therapy regimens. Here, we present first results of an ongoing multicenter evaluation.

Methodik/Methods Altogether, 261 patients ((63+/-10)y, 198m) with newly diagnosed HNSCC from four Canadian institutions available on the cancer imaging archive (https://wiki.cancerimagingarchive.net) were included. All patients received FDG-PET/CT prior to definitive radio(chemo)therapy. In the PET images, the metabolic active volume (MTV) of the primary tumor and of all FDG avid lymph nodes was delineated with an adaptive threshold method. For the resulting ROIs, SUVmax was computed. Total tumor burden (MTVtotal) was computed as the cumulative volume of primary tumor and lymph nodes. SUVtotal was defined as maximum SUVmax in primary tumor and lymph nodes. Survival analysis with respect to freedom from distant metastases was performed. A multivariate Cox regression including clinical parameters as confounding factors was performed.

Ergebnisse/Results Survival analysis revealed MTVtotal and SUVtotal as prognostic factors (p < 0.001/p = 0.009). MTV and SUVmax of the primary tumor were not prognostic (p > 0.14). Among the clinical parameters, T-stage and N-stage were prognostic (p = 0.039/p = 0.019). In multivariate analysis only SUVtotal remained a significant factor indicating its independent prognostic value.

Schlussfolgerungen/Conclusions In the investigated group of patients, the inclusion of lymph nodes significantly increased the prognostic value of FDG-PET. Further investigations are necessary to confirm these preliminary results.



Publication History

Article published online:
08 April 2021

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