Sequential FDG-PET/CT after neoadjuvant chemotherapy is a predictor of histopathologic response in patients with head and neck squamous cell carcinoma.
OBJECTIVE
To evaluate whether 2-deoxy-2-[(18)F]fluoro-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) more accurately predicts the histopathologic response to neoadjuvant chemotherapy (NAC) than magnetic resonance imaging (MRI) in patients with head and neck squamous cell carcinoma (HNSCC).


METHODS
Sixteen patients with HNSCC underwent FDG-PET/CT and MRI scans before and after one cycle of NAC, followed by surgical resection. The 26 surgically resected specimens of the 16 patients were analyzed. Decreases in maximum standardized uptake value (SUV(max)) or in tumor maximum size (diameter(max)) were calculated, and their accuracies for the prediction of histopathologic response were evaluated.


RESULTS
In histopathologic responders (n = 7), percent decreases in SUV(max) were significantly higher (P < 0.001) than in non-responders (n = 19). Applying a cut-off point of 55.5%, the histopathologic response could be predicted with a sensitivity and specificity of 86% and 95%, respectively.


CONCLUSIONS
FDG-PET/CT can predict histopathologic NAC responses with higher accuracy than MRI in HNSCC patients.
Kikuchi
Masahiro
M
Department of Otolaryngology, Kobe City Medical Center General Hospital, 4-6 Minatojima-Nakamachi, Chuo-ku, Kobe, 650-0046, Japan. masahirok@kcgh.gr.jp
Shinohara
Shogo
S
Nakamoto
Yuji
Y
Usami
Yu
Y
Fujiwara
Keizo
K
Adachi
Tsunemichi
T
Hori
Shin-ya
SY
Tona
Yosuke
Y
Yamazaki
Hiroshi
H
Imai
Yukihiro
Y
Naito
Yasushi
Y
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D049268:Positron-Emission Tomography; D012372:ROC Curve; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18