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Oral Oncol. 2018 Feb;77:98-104. doi: 10.1016/j.oraloncology.2017.12.013. Epub 2017 Dec 28.

Prediction of distant metastasis and survival in adenoid cystic carcinoma using quantitative 18F-FDG PET/CT measurements.

Author information

1
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
2
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
3
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: rohjl@amc.seoul.kr.

Abstract

OBJECTIVES:

Adenoid cystic carcinoma (AdCC) in the salivary gland shows a high rate of distant metastasis, which is related to the resulting poor prognosis. We therefore examined the role of pretreatment 18F-FDG PET/CT for prediction of distant metastasis, recurrence/progression, and survival in AdCC.

METHODS:

This study included 52 patients who underwent pretreatment 18F-FDG PET/CT scanning and subsequent treatments for AdCC. Maximum, mean, and peak standardized uptake value (SUVmax, SUVmean, and SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured on 18F-FDG PET/CT. Univariate and multivariate Cox proportional hazards regression analyses were used to identify associations between the quantitative measurements of 18F-FDG PET, and progression-free survival (PFS), distant metastasis-free survival (DMFS), and disease-specific survival (DSS).

RESULTS:

Distant metastases were found in 20 (39%) patients: 6 (12%) at initial diagnosis and 14 (27%) during the median follow-up of 72 months after treatment. Univariate analyses showed that all the 18F-FDG PET parameters of SUVmax, SUVmean, SUVpeak, MTV, and TLG were significantly associated with overall PFS, DMFS, and OS (all P < .05). After controlling for clinicopathological variables, SUVmax remained an independent factor predictive of PFS (P = .001), while MTV and TLG were independent predictors of DMFS (P = .009) and DSS (P = .017). Patients with MTV > 14.8 mL showed a 5.9-fold higher risk of distant metastasis and a 4.2-fold higher risk of disease-specific death than those with a lower MTV.

CONCLUSIONS:

Quantitative measurements using 18F-FDG PET/CT are useful for predicting tumor progression, distant metastasis, and survival in patients with AdCC.

KEYWORDS:

(18)F-FDG PET/CT; Adenoid cystic carcinoma; Distant metastasis; Progression; Risk factors

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