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Eur Radiol. 2016 Dec;26(12):4432-4441. Epub 2016 Mar 10.

Combining standardized uptake value of FDG-PET and apparent diffusion coefficient of DW-MRI improves risk stratification in head and neck squamous cell carcinoma.

Author information

1
Department of Radiology, European Institute of Oncology, Milan, Italy.
2
Specialisation School of Radiology, University of Milan, Milan, Italy. giorgioconte.unimed@gmail.com.
3
Specialisation School of Radiology, University of Milan, Milan, Italy.
4
Department of Nuclear Medicine, European Institute of Oncology, Milan, Italy.
5
Department of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
6
Department of Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
7
Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
8
Department of Urogenital Cancer Medical Treatment, European Institute of Oncology, Milan, Italy.
9
Department of Oncology and Haematology-Oncology, University of Milan, Milan, Italy.

Abstract

OBJECTIVES:

To assess the independent prognostic value of standardized uptake value (SUV) and apparent diffusion coefficient (ADC), separately and combined, in order to evaluate if the combination of these two variables allows further prognostic stratification of patients with head and neck squamous cell carcinomas (HNSCC).

METHODS:

Pretreatment SUV and ADC were calculated in 57 patients with HNSCC. Mean follow-up was 21.3 months. Semiquantitative analysis of primary tumours was performed using SUVmaxT/B, ADCmean, ADCmin and ADCmax. The prognostic value of SUVmaxT/B, ADCmean, ADCmin and ADCmax in predicting disease-free survival (DFS) was evaluated with log-rank test and Cox regression models.

RESULTS:

Patients with SUVmaxT/B ≥5.75 had an overall worse prognosis (p = 0.003). After adjusting for lymph node status and diameter, SUVmaxT/B and ADCmin were both significant predictors of DFS with hazard ratio (HR) = 10.37 (95 % CI 1.22-87.95) and 3.26 (95 % CI 1.20-8.85) for SUVmaxT/B ≥5.75 and ADCmin ≥0.58 × 10-3 mm2/s, respectively. When the analysis was restricted to subjects with SUVmaxT/B ≥5.75, high ADCmin significantly predicted a worse prognosis, with adjusted HR = 3.11 (95 % CI 1.13-8.55).

CONCLUSIONS:

The combination of SUVmaxT/B and ADCmin improves the prognostic role of the two separate parameters; patients with high SUVmaxT/B and high ADCmin are associated with a poor prognosis.

KEY POINTS:

• High SUV maxT/B is a poor prognostic factor in HNSCC • High ADC min is a poor prognostic factor in HNSCC • In patients with high SUV maxT/B , high ADC min identified those with worse prognosis.

KEYWORDS:

Diffusion-weighted imaging; Head and neck neoplasm; Magnetic resonance imaging; Positron-emission tomography; Prognosis

PMID:
26965504
DOI:
10.1007/s00330-016-4284-8
[Indexed for MEDLINE]

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