title: Pretreatment (18)F-FDG uptake heterogeneity can predict survival in patients with locally advanced nasopharyngeal carcinoma--a retrospective study.
abstract: BACKGROUND
  Intratumoural heterogeneity has been demonstrated to be a strong indicator of malignant transformation. Our study was to investigate pretreatment (18)F-FDG parameters, including (18)F-FDG based heterogeneity for predicting survival in patients with locally advanced nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  Forty newly diagnosed, biopsy-proven locally advanced NPC patients who underwent (18)F-FDG PET/CT were retrospectively included. The following PET parameters were assessed: maximum and mean standardised uptake value (SUVmax and SUVmean), metabolic tumour volume (MTV), total lesion glycolysis (TLG) and intratumoral heterogeneity index (HI). The previous parameters were recorded both for the primary tumor (-T) and neck lymph nodes (-N). The following endpoints were evaluated: local control (LC), progression-free survival (PFS) and overall survival (OS). The survival analyses were performed using the Kaplan-Meier method. Univariate analysis was performed using the log-rank test.
  
  
  RESULTS
  Patients with a lower HI-T, SUVmax-T, SUVmean-T and TLG-T had significantly better 2-year LC. In predicting PFS, we found that both lower HI-T and HI-N had significantly better prognosis. However, the OS was only statistically associated with HI-T.
  
  
  CONCLUSIONS
  (18)F-FDG based heterogeneity appears to be an potential predicator of patient survival after treatment.
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China. yangzhongyi21@163.com.|Center for Biomedical imaging, Fudan University, Shanghai, China. yangzhongyi21@163.com.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. yangzhongyi21@163.com.
authors.forename: Zhongyi
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. shiqi0723@hotmail.com.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. shiqi0723@hotmail.com.
authors.forename: Qi
authors.initials: Q
authors.lastname: Shi
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China. zhangyp@shca.org.cn.|Center for Biomedical imaging, Fudan University, Shanghai, China. zhangyp@shca.org.cn.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. zhangyp@shca.org.cn.
authors.forename: Yongping
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China. phr@shca.org.cn.|Center for Biomedical imaging, Fudan University, Shanghai, China. phr@shca.org.cn.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. phr@shca.org.cn.
authors.forename: Herong
authors.initials: H
authors.lastname: Pan
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China. yaozf@shca.org.cn.|Center for Biomedical imaging, Fudan University, Shanghai, China. yaozf@shca.org.cn.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. yaozf@shca.org.cn.
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Yao
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China. husl@shca.org.cn.|Center for Biomedical imaging, Fudan University, Shanghai, China. husl@shca.org.cn.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. husl@shca.org.cn.
authors.forename: Silong
authors.initials: S
authors.lastname: Hu
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China. sw@shca.org.cn.|Center for Biomedical imaging, Fudan University, Shanghai, China. sw@shca.org.cn.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. sw@shca.org.cn.
authors.forename: Wei
authors.initials: W
authors.lastname: Shi
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China. zbl@shca.org.cn.|Center for Biomedical imaging, Fudan University, Shanghai, China. zbl@shca.org.cn.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. zbl@shca.org.cn.
authors.forename: Beiling
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China. profzhangyj@163.com.|Center for Biomedical imaging, Fudan University, Shanghai, China. profzhangyj@163.com.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. profzhangyj@163.com.
authors.forename: Yingjian
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. hucsu62@yahoo.com.|Department of Oncology, Shanghai Medical College, Fudan University, No.270, Dong'an Road, Xuhui District, Shanghai, China. hucsu62@yahoo.com.
authors.forename: Chaosu
authors.initials: C
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000401:mortality* / Q000532:radiotherapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000401:mortality* / Q000532:radiotherapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D057234:Preoperative Period; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18