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Reflecting on the utility of standardized uptake values on (18)F-FDG PET in nasopharyngeal carcinoma

BACKGROUND: To rethink the clinical significance of standardized uptake values (SUVs) of nasopharyngeal carcinoma (NPC) on (18)F-fluorodeoxyglucose ((18)F-FDG) positron-emission tomography (PET). METHODS: We retrospectively reviewed 369 NPC patients who underwent pretreatment (18)F-FDG PET. The pred...

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Detalles Bibliográficos
Autores principales: Qiu, Xiufang, Wu, Haixia, Xu, Ting, Xie, Shihan, You, Ziqing, Hu, Yixin, Zheng, Yinghong, Liang, Zewei, Huang, Chaoxiong, Yi, Li, Li, Li, Liu, Jing, Fei, Zhaodong, Chen, Chuanben
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9069730/
https://www.ncbi.nlm.nih.gov/pubmed/35513804
http://dx.doi.org/10.1186/s12885-022-09626-w
Descripción
Sumario:BACKGROUND: To rethink the clinical significance of standardized uptake values (SUVs) of nasopharyngeal carcinoma (NPC) on (18)F-fluorodeoxyglucose ((18)F-FDG) positron-emission tomography (PET). METHODS: We retrospectively reviewed 369 NPC patients who underwent pretreatment (18)F-FDG PET. The predictive value of the SUVmax of the primary tumor (SUVmax-t) and regional lymph nodes (SUVmax-n) was evaluated using probability density functions. Receiver operating characteristic curves were used to determine optimal cutoffs for the SUVmax-n/SUVmax-t ratio (NTR). Kaplan–Meier and Cox regression analyses were used to assess survival. RESULTS: The optimal SUVmax-t and SUVmax-n cutoffs were 7.5 and 6.9, respectively. High SUVmax-t and SUVmax-n were related to local and regional recurrence, respectively. Patients with low SUVmax had better 3-year overall survival (OS). To avoid cross-sensitization of cutoff points, we stratified patients with high SUVmax into the low and high NTR groups. The 3-year distant metastasis-free survival (DMFS; 92.3 vs. 80.6%, P = 0.009), progression-free survival (PFS; 84.0 vs. 67.7%, P = 0.011), and OS (95.9 vs. 89.2%, P = 0.002) significantly differed between the high vs. low NTR groups for patients with high SUVmax. Multivariable analysis showed that NTR was an independent prognostic factor for DMFS (hazard ratio [HR]: 2.037, 95% CI: 1.039–3.992, P = 0.038), PFS (HR: 1.636, 95% CI: 1.021–2.621, P = 0.041), and OS (HR: 2.543, 95% CI: 1.214–5.325, P = 0.013). CONCLUSION: High SUVmax was associated with NPC recurrence. NTR is a potential prognosticator for DMFS, suggesting that heterogeneity in the pretreatment (18)F-FDG uptake between the primary tumor and lymph nodes is associated with high invasion and metastatic potential. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-022-09626-w.