Prognostic value of 18F-FDG PET-CT metabolic index for nasopharyngeal carcinoma.
OBJECTIVE
The purpose of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) and metabolic index (MI) from fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in patients with nasopharyngeal carcinoma (NPC).


METHODS
From October 2002 to July 2004, 41 patients with NPC who underwent (18)F-FDG PET-CT scan before and after radiotherapy were reviewed retrospectively. All patients received intensity-modulated radiotherapy using 6MV X-rays. We examined the association of MTV and the results of long-term follow-up of the patients.


RESULTS
Patients having tumors with an MTV below 30 cm(3) had significantly better 5-year overall survival (OS) (84.6:46.7%, P = 0.006) and disease-free survival (DFS) (73.1:40.0%, P = 0.014) than patients with an MTV of 30 cm(3) or greater. And the patients with MI below 130 had significantly higher 5-year OS (88.0:43.8%, P = 0.002) and DFS (76.0:37.5%, P = 0.005) than other patients. In the Cox multivariate analysis, MI and metabolic response (MR) were predictive of DFS, and we did not find a significant relationship between standard uptake value (SUV) and OS or DFS.


CONCLUSIONS
The present study shows that tumor volume parameters, especially the combination of MTV and SUV in the "metabolic index", are valuable for predicting long-term survival. High MI may be useful for identifying patients requiring more aggressive treatment.
Xie
Peng
P
Department of Radiation Oncology, Shandong Tumor Hospital and Institute, Jiyan Road 440, 250117 Jinan, Shandong, China.
Yue
Jin-Bo
JB
Zhao
Han-Xi
HX
Sun
Xin-Dong
XD
Kong
Li
L
Fu
Zheng
Z
Yu
Jin-Ming
JM
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D019788:Fluorodeoxyglucose F18; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D019275:Radiopharmaceuticals; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D018401:Sample Size; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002945:Cisplatin; D005472:Fluorouracil