title: Combining standardized uptake value of FDG-PET and apparent diffusion coefficient of DW-MRI improves risk stratification in head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  To assess the independent prognostic value of standardized uptake value (SUV) and apparent diffusion coefficient (ADC), separately and combined, in order to evaluate if the combination of these two variables allows further prognostic stratification of patients with head and neck squamous cell carcinomas (HNSCC).
  
  
  METHODS
  Pretreatment SUV and ADC were calculated in 57 patients with HNSCC. Mean follow-up was 21.3 months. Semiquantitative analysis of primary tumours was performed using SUVmaxT/B, ADCmean, ADCminand ADCmax. The prognostic value of SUVmaxT/B, ADCmean, ADCminand ADCmaxin predicting disease-free survival (DFS) was evaluated with log-rank test and Cox regression models.
  
  
  RESULTS
  Patients with SUVmaxT/B≥5.75 had an overall worse prognosis (p = 0.003). After adjusting for lymph node status and diameter, SUVmaxT/Band ADCminwere both significant predictors of DFS with hazard ratio (HR) = 10.37 (95 % CI 1.22-87.95) and 3.26 (95 % CI 1.20-8.85) for SUVmaxT/B≥5.75 and ADCmin≥0.58 × 10-3mm2/s, respectively. When the analysis was restricted to subjects with SUVmaxT/B≥5.75, high ADCminsignificantly predicted a worse prognosis, with adjusted HR = 3.11 (95 % CI 1.13-8.55).
  
  
  CONCLUSIONS
  The combination of SUVmaxT/Band ADCminimproves the prognostic role of the two separate parameters; patients with high SUVmaxT/Band high ADCminare associated with a poor prognosis.
  
  
  CONCLUSIONS
  • High SUVmaxT/Bis a poor prognostic factor in HNSCC • High ADCminis a poor prognostic factor in HNSCC • In patients with high SUVmaxT/B, high ADCminidentified those with worse prognosis.
authors.affiliation: Department of Radiology, European Institute of Oncology, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Preda
authors.affiliation: Specialisation School of Radiology, University of Milan, Milan, Italy. giorgioconte.unimed@gmail.com.
authors.forename: Giorgio
authors.identifier: http://orcid.org/0000-0002-1562-7389
authors.initials: G
authors.lastname: Conte
authors.affiliation: Specialisation School of Radiology, University of Milan, Milan, Italy.
authors.forename: Luke
authors.initials: L
authors.lastname: Bonello
authors.affiliation: Specialisation School of Radiology, University of Milan, Milan, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Giannitto
authors.affiliation: Department of Nuclear Medicine, European Institute of Oncology, Milan, Italy.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Travaini
authors.affiliation: Department of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Raimondi
authors.affiliation: Department of Radiology, European Institute of Oncology, Milan, Italy.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Summers
authors.affiliation: Department of Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Ansarin
authors.initials: A
authors.lastname: Mohssen
authors.affiliation: Department of Radiotherapy, European Institute of Oncology, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Alterio
authors.affiliation: Department of Urogenital Cancer Medical Treatment, European Institute of Oncology, Milan, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Cossu Rocca
authors.affiliation: Department of Nuclear Medicine, European Institute of Oncology, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Grana
authors.affiliation: Specialisation School of Radiology, University of Milan, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Ruju
authors.affiliation: Department of Radiology, European Institute of Oncology, Milan, Italy.|Department of Oncology and Haematology-Oncology, University of Milan, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellomi
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000378:metabolism; D038524:Diffusion Magnetic Resonance Imaging; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Diffusion-weighted imaging; Head and neck neoplasm; Magnetic resonance imaging; Positron-emission tomography; Prognosis