18F-FDG-PET/CT parameters as imaging biomarkers in oral cavity squamous cell carcinoma, is visual analysis of PET and contrast enhanced CT better than the numbers?

• Type of Material: Article
• Authors: Ayse Karagulle Kendi, Emory University; A. Tuba Kendi, Emory University; Amanda Corey, Emory University; Kelly Magliocca, Emory University; Dana C. Nickleach, Emory University; James Galt, Emory University; Jeffrey Switchenko, Emory University; Mark El-Deiry, Emory University; Jeffery Wadsworth, Emory University; Patricia Hudgins, Emory University; Nabil Saba, Emory University; David Schuster, Emory University
• Language: English
• Date: 2015-06-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 Elsevier Ireland Ltd.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ejrad.2015.02.030
• Title of Journal or Parent Work: European Journal of Radiology
• ISSN: 0720-048X
• Volume: 84
• Issue: 6
• Start Page: 1171
• End Page: 1176
• Grant/Funding Information: Research reported in this publication was supported in part by the Biostatistics & Bioinformatics Share Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292.
• Keywords: METABOLIC TUMOR VOLUME; SURVIVAL; PROGNOSTIC VALUE; Positron emission tomography; HEAD; NECK-CANCER; Squamous cell carcinoma; Computed tomography; Radiology, Nuclear Medicine & Medical Imaging; TOTAL LESION GLYCOLYSIS; Life Sciences & Biomedicine; Head and neck carcinoma; PITFALLS
• Research Categories: Health Sciences, Oncology; Health Sciences, Radiology; Health Sciences, Pathology

Abstract

Purpose: This study was designed to seek associations between positron emission tomography/computed tomography (PET/CT) parameters, contrast enhanced neck computed tomography (CECT) and pathological findings, and to determine the potential prognostic value of PET/CT and CECT parameters in oral cavity squamous cell carcinoma (OCSCC). Materials and method: 36 OCSCC patients underwent staging PET/CT and 30/36 of patients had CECT. PET/CT parameters were measured for the primary tumor and the hottest involved node, including maximum, mean, and peak standardized uptake values (SUV max, SUV mean, and SUV peak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), standardized added metabolic activity (SAM), and normalized standardized added metabolic activity (N SAM). Qualitative assessment of PET/CT and CECT were also performed. Pathological outcomes included: perineural invasion, lymphovascular invasion, nodal extracapsular spread, grade, pathologic T and N stages. Multivariable logistic regression models were fit for each parameter and outcome adjusting for potentially confounding variables. Multivariable Cox proportional hazards models were used for progression free survival (PFS), locoregional recurrence free survival (LRFS), overall survival (OS) and distant metastasis free survival (DMFS). Results: In multivariable analysis, patients with high (≥ median) tumor SUV max (OR 6.3), SUV mean (OR 6.3), MTV (OR 19.0), TLG (OR 19.0), SAM (OR 11.7) and N SAM (OR 19.0) had high pathological T-stage (T3/T4) (p < 0.05). Ring/heterogeneous pattern on CECT qualitative assessment was associated with worse DMFS and OS. Conclusion: High PET/CT parameters were associated with pathologically advanced T stage (T3/T4). Qualitative assessment of CECT has prognostic value. PET/CT parameters did not predict clinical outcome.