title: Use of 18F-FDG PET/CT as a predictive biomarker of outcome in patients with head-and-neck non-squamous cell carcinoma.
abstract: OBJECTIVE
  The purpose of this article is to establish whether pretreatment (18)F-FDG uptake predicts disease-free survival (DFS) and overall survival in patients with head-and-neck non-squamous cell carcinoma (SCC).
  
  
  METHODS
  Eighteen patients (six women and 12 men; mean [± SD] age at diagnosis, 57.89 ± 13.54 years) with head-and-neck non-SCC were included. Tumor FDG uptake was measured by the maximum standardized uptake value (SUV(max)) and was corrected for background liver FDG uptake to derive the corrected SUV(max). Receiver operating characteristic analyses were used to predict the optimal corrected SUV(max) cutoffs for respective outcomes of DFS (i.e., absence of recurrence) and death.
  
  
  RESULTS
  The mean corrected SUV(max) of the 18 head-and-neck tumors was 5.63 ± 3.94 (range, 1.14-14.29). The optimal corrected SUV(max) cutoff for predicting DFS and overall survival was 5.79. DFS and overall survival were significantly higher among patients with corrected SUV(max) < 6 than among patients with corrected SUV(max) ≥ 6. The mean DFS for patients with corrected SUV(max) < 6 was 25.7 ± 11.14 months, and the mean DFS for patients with corrected SUV(max) ≥ 6 was 7.88 ± 7.1 months (p < 0.018). Among patients with corrected SUV(max) < 6, none died, and the mean length of follow-up for this group was 35.2 ± 9.96 months. All of the patients who died had corrected SUV(max) ≥ 6, and the overall survival for this group was 13.28 ± 12.89 months (p < 0.001).
  
  
  CONCLUSIONS
  FDG uptake, as measured by corrected SUV(max), may be a predictive imaging biomarker for DFS and overall survival in patients with head-and-neck non-SCC.
authors.affiliation: Department of Radiology, Boston Medical Center and Boston University School of Medicine, Boston, MA 02118, USA.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Imsande
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Davison
authors.forename: Minh T
authors.initials: MT
authors.lastname: Truong
authors.forename: Anand K
authors.initials: AK
authors.lastname: Devaiah
authors.forename: Gustavo A
authors.initials: GA
authors.lastname: Mercier
authors.forename: Al J
authors.initials: AJ
authors.lastname: Ozonoff
authors.forename: Rathan M
authors.initials: RM
authors.lastname: Subramaniam
mesh_terms: D014408:Biomarkers, Tumor; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids / Q000493:pharmacokinetics
chemical_list: D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D014283:Triiodobenzoic Acids; D019788:Fluorodeoxyglucose F18; C054871:ioversol