Potential novel application of dual time point SUV measurements as a predictor of survival in head and neck cancer.
OBJECTIVE
To examine the potential of pre-treatment dual time point [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) as a tool for improving the assessment of head and neck cancer. Two main areas were investigated: (a) optimum time to start FDG scanning post-injection and (b) potential of SUV obtained from dual time point scanning as a prognostic indicator of survival.


METHODS
Twelve patients with advanced head and neck cancer were prospectively studied. Each patient was scanned using a Siemen's Ecat Exact-47 PET scanner at 1 h and 2 h post-injection. Maximum tumour uptake (SUVt) and ratio of maximum tumour/normal tissue uptake (SUVt/n) were recorded. The optimal time to initiate scanning was investigated by comparing SUVt and SUVt/n with the decision made by two experienced observers as to which scan they preferred to report from, given the choice of the 1 h and 2 h scan in each patient.


RESULTS
A significant difference between 1 h and 2 h SUVt (P<0.004, paired t-test) and between 1 h and 2 h SUVt/n (P<0.0003, paired t-test) was observed. All 2 h SUVt and SUVt/n were greater in magnitude than their respective 1 h SUVt and SUVt/n counterparts. The two observers reported an identical number of lesions from the 1 h and 2 h scans but preferred the 2 h data.


CONCLUSIONS
Tumour stage and the percentage difference in 1 h and 2 h SUVt showed potential as prognostic indicators of long-term survival.
Sanghera
Bal
B
Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, Middlesex, UK. b.sanghera@imperial.ac.uk
Wong
Wai Lup
WL
Lodge
Martin A
MA
Hain
Sharon
S
Stott
David
D
Lowe
John
J
Lemon
Catherine
C
Goodchild
Kate
K
Saunders
Michele
M
D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18