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Author Notes:

Corresponding author: Kendi AT. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, 1364 Clifton Rd. NE, Atlanta Ga 30322, Phone: 404-712-4843, Fax: 404-712-7435, ayse.kendi@emory.edu.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


Research Funding:

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.


  • Life Sciences & Biomedicine
  • Radiology, Nuclear Medicine & Medical Imaging
  • Positron emission tomography
  • Computed tomography
  • Squamous cell carcinoma
  • Head and neck carcinoma
  • HEAD

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?

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Journal Title:

European Journal of Radiology


Volume 84, Number 6


, Pages 1171-1176

Type of Work:

Article | Post-print: After Peer Review


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.

Copyright information:

© 2015 Elsevier Ireland Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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