Metabolic tumour volume

 

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Summary

Purpose: Evaluate the predictive and prognostic value of semi-quantitative FDG-PET variables derived from pretreatment FDG-PET images in patients suffering from locally advanced squamous cell carcinoma of the head and neck (SCCHN), treated by means of concomitant radiochemotherapy. Patients, methods: 40 patients with newly diagnosed SCCHN that were treated with concomitant radiochemotherapy underwent FDG-PET/CT for treatment planning; 18 patients had neck dissection prior to their baseline scan and to receiving radiochemotherapy. FDG-PET images were used to calculate metabolic tumour volumes using region growing and a threshold of 50% (MTV₅₀) of primary lesions and involved lymph nodes as well as the mean and maximum standard uptake value (SUVmean and SUVmax) of the primary tumours. Results: Neither SUVmean nor SUVmax values of the primary tumour were significantly different between responders and non-responders whereas MTV₅₀ values of the primary tumour proved significantly higher in non-responders. SUVmean, SUVmax and MTV₅₀ of the primary tumour were not predictive for overall or disease free survival. Contrariwise, dichotomized summed MTV₅₀ values (cut-off ≥ 31 cm³) of the primary tumour and involved lymph nodes in patients that didn’t have neck dissection prior to radiochemotherapy were predictive for disease free and overall survival in both univariate and multivariate analysis (p ≤ 0.05). Conclusion: Summed MTV₅₀ values of both the primary tumour and involved lymph nodes provided independent prognostic information on disease free and overall survival.

Zusammenfassung

Ziel: Beurteilung der prädiktiven und prognostischen Bedeutung semi-quantitativer FDG-PETVariablen, abgeleitet von prätherapeutischen FDG-PET-Aufnahmen bei Patienten mit lokal fortgeschrittenen Plattenepithelkarzinomen des Kopf-Hals-Bereichs (SCCHN), die mit einer kombinierten Radiochemotherapie behandelt wurden. Patienten, Methoden: Bei 40 Patienten mit neu diagnostizierten SCCHN, die mit kombinierter Radiochemotherapie behandelt wurden, wurde zur Therapieplanung eine FDG-PET/CT durchgeführt; bei 18 Patienten war vor dem Baseline-Scan und vor Beginn der Radiochemotherapie eine Neck-Dissection erfolgt. Anhand der FDG-PET/CT-Aufnahmen wurden die metabolischen Tumor volumina der Primärläsionen und der befallenen Lymphknoten mittels regionalen Wachstums und einer 50%-Schwelle (MTV₅₀) sowie des mittleren und maximalen Standard Uptake Value (SUVmean und SUVmax) der Primärtumore berechnet. Ergebnisse: Weder für die SUVmean- noch die SUVmax- Werte der Primärtumore bestanden signifikante Unterschiede zwischen Respondern und Non-Respondern, wohingegen sich die MTV₅₀-Werte der Primärtumore bei Non-Respondern als signifikant hoher erwiesen. SUVmean, SUVmax und MTV₅₀ der Primärtumore erlaubten keine Vorhersage für das gesamte oder das krankheitsfreie Überleben. Die dichotomisierten Summenwerte von MTV₅₀ (Cutoff ≥ 31 cm³) des Primärtumors und der befallenen Lymphknoten bei Patienten ohne Neck-Dissection waren hingegen vor der Radiochemotherapie sowohl in der univariaten als auch in der multivariaten Analyse für das krankheitsfreie Überleben und das Gesamtüberleben (p ≤ 0,05) prädiktiv. Schlussfolgerung: Die Summe der MTV₅₀-Werte aus Primärtumor und befallenen Lymphknoten liefert unabhängige prognostische Informationen zum krankheitsfreien Überleben und zum Gesamtüberleben.

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