title: Prognostic Value of Metabolic Tumor Volume Measured by (18)F-FDG PET/CT in Locally Advanced Head and Neck Squamous Cell Carcinomas Treated by Surgery.
abstract: OBJECTIVE
  We assessed the prognostic value of metabolic tumor volume (MTV) measured using(18)F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) inpatients with locally advanced head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  We retrospectively reviewed 56 patients (51 men, five women; mean age 56.0 ± 8.8years) who had locally advanced HNSCC and underwent FDG PET/CT for initial evaluation. All patients had surgical resection and radiotherapy with or without concurrent chemotherapy. The peak standardized uptake value (SUVpeak) and MTV of the target lesion, including primary HNSCC andmetastatic cervical lymph nodes, were measured from FDG PET/CT images. We compared SUVpeak, MTV, and clinicopathologic variables such as age, Eastern Cooperative Oncology Group (ECOG) performance status, pN stage, pT stage, TNM stage, histologic grade and treatment modality to disease-free survival (DFS) and overall survival (OS).
  
  
  RESULTS
  On the initial FDG PET/CT scans, the median SUVpeak was 7.8 (range, 1.8-19.0) and MTV was17.0 cm(3) (range, 0.1-131.0 cm(3)). The estimated 2-year DFS and OS rates were 67.2% and 81.8%. The cutoff points of SUVpeak 6.2 and MTV 20.7 cm(3) were the best discriminative values for predicting clinical outcome. MTV and ECOG performance status were significantly related to DFS and OS on univariate and multivariate analyses (p < 0.05).
  
  
  CONCLUSIONS
  The MTV obtained from initial FDG PET/CT scan is a significant prognostic factor for disease recurrence and mortality in locally advanced HNSCC treated with surgery and radiotherapy with or without chemotherapy.
authors.affiliation: Department of Radiology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Kyu-Ho
authors.initials: KH
authors.lastname: Choi
authors.affiliation: Department of Radiology, The Catholic University of Korea, Seoul, Korea ; Department of Nuclear Medicine, Seoul St.Mary's Hospital, The Catholic University of Korea, Seochogu Banpodong 505, Seoul, Korea 137-701.
authors.forename: Ie Ryung
authors.initials: IeR
authors.lastname: Yoo
authors.affiliation: Department of Radiology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Han
authors.affiliation: Department of Radiation Oncology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yeon Sil
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Gi Won
authors.initials: GW
authors.lastname: Kim
authors.affiliation: Department of Radiology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sae Jung
authors.initials: SJ
authors.lastname: Na
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, Seoul, Korea.
authors.forename: Dong-Il
authors.initials: DI
authors.lastname: Sun
authors.affiliation: Department of Radiology, The Catholic University of Korea, Seoul, Korea.
authors.forename: So Lyung
authors.initials: SL
authors.lastname: Jung
authors.affiliation: Department of Hospital Pathology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Chan-Kwon
authors.initials: CK
authors.lastname: Jung
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, Seoul, Korea.
authors.forename: Min-Sik
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Radiology, The Catholic University of Korea, Seoul, Korea.
authors.forename: So-Yeon
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Radiology, The Catholic University of Korea, Seoul, Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
keywords: FDG PET/CT; Head and neck squamous cell carcinoma; Metabolic tumor volume; Prognostic factor; Surgery