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DOI:10.2214/AJR.08.1429
AJR 2009; 192:W156-W160
© American Roentgen Ray Society

Clinical Observations

Prognostic Value of 18F-FDG PET in Patients with Head and Neck Squamous Cell Cancer

Tatsuo Torizuka1,2, Yasuo Tanizaki1, Toshihiko Kanno1, Masami Futatsubashi3, Katsumi Naitou4, Yo Ueda5 and Yasuomi Ouchi1

1 Positron Medical Center, Hamamatsu Medical Center, Hamamatsu, Japan.
2 Present address: Research Center for Child Mental Development, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan.
3 Central Research Laboratory, Hamamatsu Photonics K.K., Hamamatsu, Japan.
4 Department of Oral Surgery, Hamamatsu Medical Center, Hamamatsu, Japan.
5 Department of Otorhinolaryngology, Hamamatsu Medical Center, Hamamatsu, Japan.

OBJECTIVE. This study was designed to assess whether tumor uptake of 18F-FDG (FDG) expressed as the standardized uptake value (SUV) can be used to predict survival in patients with head and neck cancer. Furthermore, a prognostic maximum SUV was determined with univariate and bivariate analyses.

CONCLUSION. Low SUVs (≤ 7.0) predicted significantly higher rates of 2-year local control (p = 0.0067) and disease-free survival (p = 0.0051) as compared with high SUVs (> 7.0). In the Cox proportional hazards model, tumor SUV was a significant and independent predictor of local control (p = 0.022) and disease-free survival (p = 0.019). In addition, in the group of high SUV, high T stage was more associated with poorer outcome than low T stage (p = 0.0502). Therefore, patients with higher tumor FDG uptake should be considered for a more aggressive treatment approach.

Keywords: FDG PET • head and neck cancer • prognosis • standardized uptake value


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