Use of 18F-FDG PET/CT as a Predictive Biomarker of Outcome in Patients With Head-and-Neck Non-Squamous Cell Carcinoma

OBJECTIVE. The purpose of this article is to establish whether pretreatment (18)F-FDG uptake predicts disease-free survival (DFS) and overall survival in patients with head-and-neck non-squamous cell carcinoma (SCC). MATERIALS AND METHODS. Eighteen patients (six women and 12 men; mean [+/- SD] age at diagnosis, 57.89 +/- 13.54 years) with head-and-neck non-SCC were included. Tumor FDG uptake was measured by the maximum standardized uptake value (SUV(max)) and was corrected for background liver FDG uptake to derive the corrected SUV(max). Receiver operating characteristic analyses were used to predict the optimal corrected SUV(max) cutoffs for respective outcomes of DFS (i.e., absence of recurrence) and death. RESULTS. The mean corrected SUV(max) of the 18 head-and-neck tumors was 5.63 +/- 3.94 (range, 1.14-14.29). The optimal corrected SUV(max) cutoff for predicting DFS and overall survival was 5.79. DFS and overall survival were significantly higher among patients with corrected SUV(max) < 6 than among patients with corrected SUV(max) = 6. The mean DFS for patients with corrected SUV(max) < 6 was 25.7 +/- 11.14 months, and the mean DFS for patients with corrected SUV(max) = 6 was 7.88 +/- 7.1 months (p < 0.018). Among patients with corrected SUV(max) < 6, none died, and the mean length of follow-up for this group was 35.2 +/- 9.96 months. All of the patients who died had corrected SUV(max) = 6, and the overall survival for this group was 13.28 +/- 12.89 months (p < 0.001). CONCLUSION. FDG uptake, as measured by corrected SUV(max), may be a predictive imaging biomarker for DFS and overall survival in patients with head-and-neck non-SCC.