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Intratumor Textural Heterogeneity on Pretreatment 18F-FDG PET Images Predicts Response and Survival After Chemoradiotherapy for Hypopharyngeal Cancer

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

An Erratum to this article was published on 22 January 2015

Abstract

Background

Increasing evidence suggests that intratumor heterogeneity of solid tumors characterized by textural features on 18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) images is associated with response to chemoradiotherapy (CRT) and survival. The current study aimed to determine whether a similar relationship exists in hypopharyngeal squamous cell carcinoma (HPSCC).

Methods

This study investigated 27 patients with HPSCC who underwent cisplatin-based induction chemotherapy followed by definitive CRT underwent pretreatment 18F-FDG PET/CT. Standardized uptake value (SUV), metabolic tumor volume (MTV), and textural features (coarseness, busyness, complexity, and contrast) of primary tumors were measured. Patients were classified as nonresponders or responders according to the response evaluation criteria in solid tumors. The capacity of each parameter to classify response was assessed using the Mann–Whitney U test. Cox-proportional hazard models were used to identify variables associated with disease-free survival (DFS) and overall survival (OS).

Results

Of 70 patients, 58 (83 %) had complete or partial response after CRT. Responders showed lower maximum SUV (P = 0.037), lower MTV (P = 0.039), lower coarseness (P < 0.001), and busyness (P = 0.015) compared with nonresponders. Multivariate analysis showed that high coarseness (P = 0.001, hazard ratio [HR] 5.65; 95 % confidence interval [CI] 2.12–15.07) and busyness (P = 0.045; HR 2.56; 95 % CI 1.02–6.42) were independently associated with poor DFS, and that high coarseness (P = 0.013; HR 2.48; 95 % CI 1.21–5.09) was independently associated with poor OS.

Conclusion

Abnormal coarseness in baseline 18F-FDG PET scans may be useful for predicting response and survival after CRT in HPSCC patients.

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Acknowledgment

This study was supported by Grant No. 2014-0306 from the Asan Institute for Life Science and by Grant No. NRF-2012R1A1A2002039 from the Basic Science Research Program through the National Research Foundation of Korea and the Ministry of Education, Science and Technology, Seoul, Korea (J.-L.R.).

Conflict of interest

There are no conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Jungsu S. Oh PhD & Jae Seung Kim MD

  2. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Bung Chul Kang MD, Jong-Lyel Roh MD, Seung-Ho Choi MD, Soon Yuhl Nam MD & Sang Yoon Kim MD

  3. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Kyung-Ja Cho MD

  4. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Sang-wook Lee MD

  5. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Sung-Bae Kim MD

  6. Biomedical Research Institute, Korea Institute of Science and Technology, Seoul, Republic of Korea

    Sang Yoon Kim MD

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  1. Jungsu S. Oh PhD
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Correspondence to Jong-Lyel Roh MD.

Additional information

Jungsu S. Oh, and Bung Chul Kang have contributed equally to this paper.

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10434_2014_4284_MOESM1_ESM.tif

Receiver operating characteristic curves of complete or partial response after chemoradiotherapy according to maximum and peak standardized uptake value (SUVmax and SUVpeak), metabolic tumor volume (MTV), and tumor coarseness on 18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) images. (TIFF 967 kb)

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Oh, J.S., Kang, B.C., Roh, JL. et al. Intratumor Textural Heterogeneity on Pretreatment 18F-FDG PET Images Predicts Response and Survival After Chemoradiotherapy for Hypopharyngeal Cancer. Ann Surg Oncol 22, 2746–2754 (2015). https://doi.org/10.1245/s10434-014-4284-3

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