Prognostic value of 99mTc-HYNIC annexin-V imaging in squamous cell carcinoma of the head and neck.
OBJECTIVE
The purpose of the study was to report on the prognostic value of (99m)Tc-hydrazinonicotinamide (HYNIC) Annexin-V single-photon emission computed tomography (SPECT) imaging in patients suffering from primary squamous cell carcinoma of the head and neck.


METHODS
Twenty-nine patients diagnosed with a primary untreated head and neck squamous cell carcinoma were included in this study. In all patients, (99m)Tc-HYNIC Annexin-V scintigraphy SPECT was performed before treatment instigation. Tumour-to-background ratios (T/N) of the primary tumour, derived from reconstructed images, as well as clinical variables were obtained in all patients and related to patient outcome. Median follow-up was 22.6 months (range 4.1-55.8 months).


RESULTS
On univariate as well as multivariate analysis, only the (99m)Tc-HYNIC Annexin-V T/N ratio dichotomized using the group median as cutoff value (T/N ratio of 2) was predictive of recurrence-free survival (respectively, p = 0.0000 and 0.000). On univariate analysis, only lymph node status dichotomized according to N0 vs N1-N2-N3 disease and the (99m)Tc-HYNIC Annexin-V T/N ratio dichotomized using the group median as cutoff value (T/N ratio of 2) were predictive of overall survival (p = 0.0051 and 0.0000). When both factors were included in the multivariate model, both N status and the (99m)Tc-HYNIC Annexin-V T/N ratio showed an independent association with overall survival (p = 0.001 for lymph node status and 0.000 for dichotomized (99m)Tc-HYNIC Annexin-V T/N ratio).


CONCLUSIONS
(99m)Tc-HYNIC Annexin-V T/N ratios derived from SPECT provides independent prognostic information on disease-free survival and overall survival.
Loose
David
D
Department of Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium.
Vermeersch
Hubert
H
De Vos
Filip
F
Deron
Philippe
P
Slegers
Guido
G
Van de Wiele
Christophe
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017304:Annexin A5; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011379:Prognosis; D015899:Tomography, Emission-Computed, Single-Photon
D017304:Annexin A5; D015609:Organotechnetium Compounds; C117287:technetium Tc 99m HYNIC annexin V