18F-FDG-PET for evaluation of the response to concurrent chemoradiation therapy with intensity-modulated radiation technique for Stage T4 nasopharyngeal carcinoma.
OBJECTIVE
This article evaluates [18F] fluorodeoxyglucose positron emission tomography (18F-FDG-PET) findings as a predictor for local responders (R) vs. nonresponders (NR) in nasopharyngeal carcinoma (NPC) patients with Stage T4 lesions, before and at 3 months after completion of concurrent chemotherapy and radiation therapy (CCRT).


METHODS
From January 2002 to November 2003, 39 T4 NPC patients were enrolled. All had magnetic resonance imaging and 18F-FDG-PET, both before and 3 months after CCRT. Any residual/recurrent lesions were confirmed histopathologically.


RESULTS
Of the 39 eligible patients, after a follow-up of 24.2 +/- 9.5 months, 35 became disease-free and 4 had residual or recurrent disease. Marginal differences in standard uptake values (SUV) were observed (10.9 +/- 5.3 vs. 15.6 +/- 3.4, p = 0.058) between R and NR before treatment, and value changes of SUV before and after CCRT were not significantly different. However, highly significantly lower values of SUV were noted for R than for NR 3 months after completion of CCRT (2.1 +/- 0.8 vs. 5.5 +/- 3.2, p = 0.001). One hundred percent positive and negative predictive values were observed for SUV values of 4.0, set 3 months after completion of CCRT.


CONCLUSIONS
Neither the pretreatment SUV nor the changes of SUV between pretreatment and posttreatment were significant predictors for local response. SUV at 3 months after completion of CCRT was a significant determinator for local response. The cutoff of 4.0 for SUV at 3 months after completion of CCRT was useful to be offered as a diagnostic reference for recurrent or residual tumor for NPC treatment.
Yen
Tzu-Chen
TC
Molecular Imaging Center, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan.
Lin
Chien-Yu
CY
Wang
Hung-Ming
HM
Huang
Shiang-Fu
SF
Liao
Chun-Ta
CT
Kang
Chung-Jan
CJ
Ng
Shu-Hang
SH
Chan
Sheng-Chieh
SC
Fan
Kang-Hsing
KH
Chen
I-How
IH
Lin
Wuu-Jyh
WJ
Cheng
Ann-Joy
AJ
Chang
Joseph Tung-Chieh
JT
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D018709:Statistics, Nonparametric
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18