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ORIGINAL ARTICLE
Year : 2014  |  Volume : 13  |  Issue : 2  |  Page : 102-107

The Anatomical Biological Value on Pretreatment 18 F-fluorodeoxyglucose Positron Emission Tomography Computed Tomography Predicts Response and Survival in Locally Advanced Head and Neck Cancer


1 Department of Radiation Oncology, NY Methodist Hospital, Weill Medical College of Cornell University, Brooklyn, NY 11215; Department of Radiation Oncology, Leading Edge Radiation Oncology Services, Brooklyn, NY 11209, USA
2 Department of Radiation Oncology, NY Methodist Hospital, Weill Medical College of Cornell University, Brooklyn, NY 11215, USA

Correspondence Address:
Dr. Ajay Tejwani
506 Sixth Street, Brooklyn, NY 11215
USA
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DOI: 10.4103/1450-1147.139139

PMID: 25191124

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18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has become increasingly relevant in the staging of head and neck cancers, but its prognostic value is controversial. The objective of this study was to evaluate different PET/CT parameters for their ability to predict response to therapy and survival in patients treated for head and neck cancer. A total of 28 consecutive patients with a variety of newly diagnosed head and neck cancers underwent PET/CT scanning at our institution before initiating definitive radiation therapy. All underwent a posttreatment PET/CT to gauge tumor response. Pretreatment PET/CT parameters calculated include the standardized uptake value (SUV) and the anatomical biological value (ABV), which is the product of SUV and greatest tumor diameter. Maximum and mean values were studied for both SUV and ABV, and correlated with response rate and survival. The mean pretreatment tumor ABV max decreased from 35.5 to 7.9 (P = 0.0001). Of the parameters tested, only pretreatment ABV max was significantly different among those patients with a complete response (CR) and incomplete response (22.8 vs. 65, respectively, P = 0.021). This difference was maximized at a cut-off ABV max of 30 and those patients with ABV max < 30 were significantly more likely to have a CR compared to those with ABV max of ≥ 30 (93.8% vs. 50%, respectively, P = 0.023). The 5-year overall survival was 80% compared to 36%, respectively, (P = 0.028). Multivariate analysis confirmed that ABV max was an independent prognostic factor. Our data supports the use of PET/CT, and specifically ABV max , as a prognostic factor in head and neck cancer. Patients who have an ABV max ≥ 30 were more likely to have a poor outcome with chemoradiation alone, and a more aggressive trimodality approach may be indicated in these patients.


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