title: Prognostic significance of the intratumoral heterogeneity of (18) F-FDG uptake in oral cavity cancer.
abstract: BACKGROUND
  We evaluated the prognostic value of the intratumoral heterogeneity of (18) F-FDG uptake in oral cavity cancer.
  
  
  METHODS
  We enrolled 45 patients who underwent pretreatment (18) F-FDG PET/CT. The intratumoral heterogeneity of (18) F-FDG uptake was represented as the heterogeneity factor (HF), defined as the derivative (dV/dT) of a volume-threshold function for a primary tumor. We measured the maximum standardized uptake value (SUVmax ) and volumetric PET parameters. The relationship between HF and clinical parameters, as well as other PET parameters, was evaluated.
  
  
  RESULTS
  The HF was significantly correlated with SUVmax (r = -0.353, P = 0.017), metabolic tumor volume (r = -0.708, P < 0.0001), and total lesion glycolysis (r = -0.709, P < 0.0001). A multivariate analysis revealed not only cervical lymph node metastasis (hazard ratio = 5.983; P = 0.022) but also HF (hazard ratio = 2.49 × 10(-4) ; P = 0.002) to be independent predictors of overall survival. Those patients with HF < -0.13 showed a worse prognosis than those with HF ≥ -0.13 (P = 0.005).
  
  
  CONCLUSIONS
  The intratumoral heterogeneity of (18) F-FDG uptake may be a significant prognostic factor for overall survival in addition to cervical lymph node metastasis in oral cavity cancer. J. Surg. Oncol. 2014 110:702-706. © 2014 Wiley Periodicals, Inc.
authors: Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea.
authors: Soo Hyun
authors: SH
authors: Kwon
authors: Joon-Kee
authors: JK
authors: Yoon
authors: Young-Sil
authors: YS
authors: An
authors: Yoo Seob
authors: YS
authors: Shin
authors: Chul-Ho
authors: CH
authors: Kim
authors: Dong Hyun
authors: DH
authors: Lee
authors: Kyung Sook
authors: KS
authors: Jo
authors: Su Jin
authors: SJ
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018196:Carcinoma, Adenosquamous / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000473:pathology; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: fluorine 18-fluorodeoxyglucose (18F-FDG); intratumoral heterogeneity; oral cavity cancer; positron emission tomography/computed tomography (PET/CT); prognosis