Influence of volumetric 4'-[methyl-11C]-thiothymidine PET/CT parameters for prediction of the clinical outcome of head and neck cancer patients.
OBJECTIVE
This prospective study compared the value of pretreatment 4'-[methyl-11C]-thiothymidine (11C-4DST) volumetric parameters and those of 2-deoxy-2-[18F] fluoro-D-glucose (18F-FDG) in predicting the clinical outcome in patients with head and neck squamous cell carcinoma (HNSCC).


METHODS
Fifty patients with HNSCC underwent11C-4DST PET/CT and18F-FDG PET/CT prior to anticancer therapy.18F-FDG metabolic tumor volume (18F-FDG MTV) and total lesion glycolysis (TLG) were calculated from18F-FDG PET, and11C-4DST MTV and total lesion proliferation (TLP) were calculated from11C-4DST PET. All parameters were measured for the primary lesion and metastatic lymph nodes. Associations between clinical factors and PET/CT parameters and prognostic value were analyzed.


RESULTS
Receiver-operating characteristic analysis revealed that MTV, TLG, and TLP acquired from the primary lesion and metastatic lymph nodes were good parameters for predicting disease relapse and death. The area under the curves (AUCs) ranged from 0.63 to 0.71 for18F-FDG PET/CT parameters. The AUCs of11C-4DST PET/CT parameters were larger than those of18F-FDG (range 0.72-0.81). Univariate analysis revealed that individuals with tumors showing a high value for any PET/CT parameter were at a significantly increased risk of relapse. Upon multivariate analysis,18F-FDG MTV,11C-4DST MTV and11C-4DST TLP were significant independent factors for relapse-free survival (P = 0.04, P = 0.0001 and P = 0.0005, respectively).


CONCLUSIONS
Pretreatment11C-4DST PET/CT volume-based parameters can provide important prognostic information about patients with HNSCC.
Department of Otolaryngology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan. hiro@med.kagawa-u.ac.jp.
Hiroshi
H
Hoshikawa
Department of Otolaryngology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan.
Terushige
T
Mori
Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Yukito
Y
Maeda
Department of Otolaryngology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan.
Satoshi
S
Takahashi
Department of Otolaryngology, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, Kagawa, Japan.
Yohei
Y
Ouchi
Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Yuka
Y
Yamamoto
Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
Yoshihiro
Y
Nishiyama
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D000077195:Squamous Cell Carcinoma of Head and Neck; D013872:Thionucleosides; D013936:Thymidine / Q000031:analogs & derivatives*; D047368:Tumor Burden
D013872:Thionucleosides; D019788:Fluorodeoxyglucose F18; C070456:4'-thiothymidine; D013936:Thymidine
11C-4DST PET/CT; 18F-FDG PET/CT; Head and neck carcinoma; Metabolic tumor volume; Total lesion proliferation