ABSTRACT
OBJECTIVE: To compare the prognostic utility of the 2-[(18)F] fluoro-2-deoxy-D: -glucose (FDG) maximum standardized uptake value (SUV(max)), primary gross tumor volume (GTV), and FDG metabolic tumor volume (MTV) for disease control and survival in patients with head and neck squamous cell carcinoma (HNSCC) undergoing intensity-modulated radiotherapy (IMRT). METHODS: Between 2007 and 2011, 41 HNSCC patients who underwent a staging positron emission tomography with computed tomography and definitive IMRT were identified. Local (LC), nodal (NC), distant (DC), and overall (OC) control, overall survival (OS), and disease-free survival (DFS) were assessed using the Kaplan-Meier product-limit method. RESULTS: With a median follow-up of 24.2 months (range 2.7-56.3 months) local, nodal, and distant recurrences were recorded in 10, 5, and 7 patients, respectively. The median SUV(max), GTV, and MTV were 15.8, 22.2 cc, and 7.2 cc, respectively. SUV(max) did not correlate with LC (p = 0.229) and OS (p = 0.661) when analyzed by median threshold. Patients with smaller GTVs (<22.2 cc) demonstrated improved 2-year actuarial LC rates of 100 versus 56.4 % (p = 0.001) and OS rates of 94.4 versus 65.9 % (p = 0.045). Similarly, a smaller MTV (<7.2 cc) correlated with improved 2-year actuarial LC rates of 100 versus 54.2 % (p < 0.001) and OS rates of 94.7 versus 64.2 % (p = 0.04). Smaller GTV and MTV correlated with improved NC, DC, OC, and DFS, as well. CONCLUSION: GTV and MTV demonstrate superior prognostic utility as compared to SUV(max), with larger tumor volumes correlating with inferior local control and overall survival in HNSCC patients treated with definitive IMRT.
Subject(s)
Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Head and Neck Neoplasms/metabolism , Head and Neck Neoplasms/pathology , Multimodal Imaging , Positron-Emission Tomography , Radiotherapy, Intensity-Modulated , Tomography, X-Ray Computed , Tumor Burden , Adult , Aged , Aged, 80 and over , Biological Transport , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/radiotherapy , Female , Head and Neck Neoplasms/diagnostic imaging , Head and Neck Neoplasms/radiotherapy , Humans , Male , Middle Aged , Neoplasm Staging , Prognosis , Retrospective Studies , Treatment FailureABSTRACT
OBJECTIVE: Metastasis is the most common (95%) of liver lesions. Early diagnosis and staging are the keys to treatment planning and prognosis. There is a consistent benefit to the use of PET/CT for detecting hepatic, local, and distant metastases from a variety of primary malignancies, which can contribute to staging and ultimately helps to establish the best course of treatment and to determine prognosis. CONCLUSION: For colorectal cancer, FDG PET and FDG PET/CT are particularly effective for identification of additional hepatic and extrahepatic metastases, frequently upstaging the tumor stage and affecting management. In addition, PET/CT is very useful in local ablative and systemic therapy assessment and surveillance for liver metastases.
Subject(s)
Liver Neoplasms/diagnostic imaging , Liver Neoplasms/secondary , Biomarkers, Tumor/analysis , Fluorodeoxyglucose F18 , Humans , Liver Neoplasms/therapy , Neoplasm Staging , Radiography , Radionuclide Imaging , Radiopharmaceuticals , Sensitivity and SpecificityABSTRACT
OBJECTIVE: Primary hepatobiliary malignancies consist of hepatocellular carcinoma, cholangiocarcinoma, and gallbladder cancer. Benign hepatic lesions include hepatic cysts, hemagiomas, adenomas, and focal nodular hyperplasias. The utility of PET/CT in imaging primary hepatobiliary lesions varies according to the type and location of the lesion. CONCLUSION: There is a consistent benefit to the use of PET/CT for detection and staging, and it ultimately helps to establish the best course of treatment and to determine prognosis. In addition, PET/CT is very useful in local ablative and systemic therapy assessment and surveillance for hepatobiliary malignancies.
