title: 18F-FDG-PET for evaluation of the response to concurrent chemoradiation therapy with intensity-modulated radiation technique for Stage T4 nasopharyngeal carcinoma.
abstract: 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.
authors.affiliation: Molecular Imaging Center, Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
authors.forename: Chien-Yu
authors.initials: CY
authors.lastname: Lin
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.forename: Shiang-Fu
authors.initials: SF
authors.lastname: Huang
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
authors.forename: Chung-Jan
authors.initials: CJ
authors.lastname: Kang
authors.forename: Shu-Hang
authors.initials: SH
authors.lastname: Ng
authors.forename: Sheng-Chieh
authors.initials: SC
authors.lastname: Chan
authors.forename: Kang-Hsing
authors.initials: KH
authors.lastname: Fan
authors.forename: I-How
authors.initials: IH
authors.lastname: Chen
authors.forename: Wuu-Jyh
authors.initials: WJ
authors.lastname: Lin
authors.forename: Ann-Joy
authors.initials: AJ
authors.lastname: Cheng
authors.forename: Joseph Tung-Chieh
authors.initials: JT
authors.lastname: Chang
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18