title: 18F-fluoromisonidazole positron emission tomography before treatment is a predictor of radiotherapy outcome and survival prognosis in patients with head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  To evaluate the usefulness of [(18)F]fluoromisonidazole ([(18)F]FMISO)-positron emission tomography (PET) prior to the treatment of head and neck squamous cell carcinoma.
  
  
  METHODS
  Seventeen patients with untreated HNSCC underwent pretreatment [(18)F]FMISO PET. Six of them underwent definitive surgery and the remaining 11 definitive (chemo-)radiotherapy. We evaluated 30 lesions from the 17 patients. SUVmax and tumor-to-muscle ratios (TMR) were measured as hypoxia indicators. Tumors equal to or above the median value were defined as tumor with high uptake of [(18)F]FMISO and those below as tumor with low uptake of [(18)F]FMISO in both indicators. Local control rates with radiotherapy, event-free survival and disease-specific survival (DSS) rates with radiotherapy or operation were compared.
  
  
  RESULTS
  [(18)F]FMISO-PET imaging of 30 lesions resulted in a SUVmax median value of 2.3 and a TMR median value of 1.3. Local control rates with radiotherapy (20-month median follow-up duration) were significantly lower in the tumor group with high uptake of [(18)F]FMISO compared to the tumor group with low uptake of [(18)F]FMISO using either SUVmax or TMR as the hypoxic indicator (P = 0.02 and 0.04, respectively). DSS rate with radiotherapy or operation (21-month median follow-up duration) was significantly lower in the patient group with high uptake of [(18)F]FMISO compared to the patient group with low uptake of [(18)F]FMISO defined by SUVmax (P = 0.04), but was not by TMR (P = 0.57).
  
  
  CONCLUSIONS
  Radiotherapy outcome and survival prognosis (radiotherapy or operation) in HNSCC may be predicted by carrying out [(18)F]FMISO PET before treatment.
authors: Department of Otolaryngology, Head and Neck Surgery, Kobe City Medical Center General Hospital, 4-6 Minatojima-Nakamachi, Chuo-ku, Kobe 650-0046, Japan. kikuchan0414@gmail.com
authors: Masahiro
authors: M
authors: Kikuchi
authors: Tomohiko
authors: T
authors: Yamane
authors: Shogo
authors: S
authors: Shinohara
authors: Keizo
authors: K
authors: Fujiwara
authors: Shin-ya
authors: SY
authors: Hori
authors: Yosuke
authors: Y
authors: Tona
authors: Hiroshi
authors: H
authors: Yamazaki
authors: Yasushi
authors: Y
authors: Naito
authors: Michio
authors: M
authors: Senda
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D015687:Cell Hypoxia; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008920:Misonidazole / Q000031:analogs & derivatives*; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: C031843:fluoromisonidazole; D008920:Misonidazole