title: Tumor stage, tumor site and HPV dependent correlation of perfusion CT parameters and [18F]-FDG uptake in head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  This study investigated whether tumor perfusion, FDG uptake and their correlation depend on tumor stage, site and HPV in head and neck cancer.
  
  
  METHODS
  41/55 eligible patients with integrated FDG-PET/perfusion CT from 2 prospective studies were assessed. A GTV(CT) and GTV(PET) were created. Perfusion maps were calculated using singular value decomposition method. Blood volume (BV), blood flow (BF), mean transit time (MTT) and standardized uptake value (SUV) in the tumor were compared to the surrounding tissue using Wilcoxon test and Spearman correlation of perfusion and SUVmean in the tumor was studied (p=0.05).
  
  
  RESULTS
  Perfusion parameters were significantly increased in the GTV(CT) of advanced tumors in comparison to the surrounding soft tissue (p<0.01). Oral cavity and oropharyngeal cancer showed a higher BF than laryngeal cancer (p<0.04). No correlation between perfusion and SUVmean was found, however SUVmean correlated significantly with BF for the HPV-positive tumors (r=0.86, p=0.04) and with BV for the oropharyngeal cancer (r=0.63, p=0.05).
  
  
  CONCLUSIONS
  Tumor stage, site and HPV are associated with different perfusion or combined perfusion/SUV signatures. Further studies are needed to investigate if these signatures co-determine clinical outcome.
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland. Electronic address: Marta.Nesteruk@usz.ch.
authors.forename: Marta
authors.initials: M
authors.lastname: Nesteruk
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lang
authors.affiliation: Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Switzerland; Department of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Veit-Haibach
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Studer
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Sonja
authors.initials: S
authors.lastname: Stieb
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Glatz
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Hossein
authors.initials: H
authors.lastname: Hemmatazad
authors.affiliation: Institute of Clinical Pathology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Kristian
authors.initials: K
authors.lastname: Ikenberg
authors.affiliation: Department of Otorhynolaryngeology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Huber
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Pruschy
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Guckenberger
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Klöck
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Riesterer
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000821:virology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology / Q000821:virology; D030361:Papillomavirus Infections / Q000150:complications* / Q000378:metabolism; D049268:Positron-Emission Tomography / Q000379:methods; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: CT perfusion; FDG PET; Head and neck cancer