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Head and neck squamous cell cancer (stages III and IV ) induction chemotherapy assessment: Value of FDG volumetric imaging parameters
Author(s) -
Yu Jielin,
Cooley Timothy,
Truong MinhTam,
Mercier Gustavo,
Subramaniam Rathan M.
Publication year - 2014
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12081
Subject(s) - medicine , induction chemotherapy , nuclear medicine , cancer , stage (stratigraphy) , receiver operating characteristic , head and neck cancer , chemotherapy , head and neck , positron emission tomography , surgery , paleontology , biology
To evaluate whether the change in the metabolic tumour volume ( MTV ) or total lesion glycolysis ( TLG ) of the primary tumour, before and after induction chemotherapy, predicts outcome for patients with advanced head and neck squamous cell cancer ( SCC ). Methods Twenty‐eight patients with advanced ( A merican J oint C ommittee on C ancer stage III and IV ) head and neck SCC who underwent positron emission tomography ( PET )/ CT were included in this retrospective study. Primary tumour MTV and TLG were measured using gradient and fixed percentage threshold segmentations. Outcome endpoint was disease progression or mortality. Pearson correlation, Bland–Altman and receiver operator characteristic analysis were performed. Results The Pearson's correlation coefficients between percentage changes (pre‐ and post‐induction chemotherapy) from gradient MTV ( MTV G ) and the 38% SUV max threshold MTV ( MTV 38 ) was 0.96 and between MTV G and the 50% threshold MTV ( MTV 50 ) was 0.95 ( P < 0.0001). The corresponding Pearson r between TLG G and TLG 38 was 0.94 and between TLG G and TLG 50 was 0.96 ( P < 0.0001). The least bias was 1.89% (standard deviation = 25.30%) between the percentage changes of MTV G and MTV 50 . The areas under the curve for predicting progression or mortality were 0.76 ( P = 0.03) for MTV G and 0.82 for TLG G ( P = 0.009). Optimum cut points of a 42% reduction in MTV G and a 55% reduction in the TLG G predict event‐free survival with a sensitivity of 62.5% and a specificity of 90% and a hazards ratio of 6.25. Conclusion A reduction in primary tumour MTV of at least 42% or in TLG of at least 55% after induction chemotherapy may predict event‐free survival in patients with advanced head and neck SCC .