Prediction of prognosis using standardized uptake value of 2-[(18)F] fluoro-2-deoxy-d-glucose positron emission tomography for nasopharyngeal carcinomas.

Abstract

To evaluate the prognostic significance of 2-[F-18]fluoro-2-deoxy-D-glucose positron emission tomography ([(18)F]FDG-PET) at diagnosis by calculating maximal standard uptake values (SUV(max)) in patients with non-disseminated nasopharyngeal carcinoma (NPC) receiving concurrent chemo-radiotherapy (CCRT). [(18)F]FDG-PET was performed in 41 patients with non-disseminated NPC scheduled to undergo platinum-based CCRT. [(18)F]FDG uptake by primary tumors and neck nodes was measured with the SUV(max). Complete response occurred in all 41 patients. The ten patients who presented with any component of treatment failure had a significantly higher SUV(max) than the remaining patients. The median SUV(max) of all patients was 6.48 (range: 2.31-26.07). Patients having tumors with high [(18)F]FDG uptake (median or greater) had a significantly lower 3-year disease free survival (DFS) rate than patients with lower tumor [(18)F]FDG uptake (less than median) (51% vs 91%, P=0.0070). Patients with an SUV(max) below 8 had a higher DFS than patients with an SUV(max) of 8 or greater. [(18)F]FDG uptake, as measured by the SUV(max), may predict DFS in CCRT-treated NPC. High [(18)F]FDG uptake may be useful for identifying patients requiring more aggressive treatment.