Predictive Value of <sup>18</sup>F-Fluorodeoxyglucose Positron-Emission Tomography Metabolic and Volumetric Parameters for Systemic Metastasis in Tonsillar Cancer
Although the prognosis of tonsillar cancer (human papillomavirus-positive oropharyngeal squamous cell carcinoma) is improving, disease control failure (distant metastasis) still occurs in some cases. We explored whether several <sup>18</sup>F-fluorodeoxyglucose (FDG) positron-emission to...
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MDPI AG
2022-12-01
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author | Jooin Bang Hye Lim Park Ie Ryung Yoo Hyun-Il Shin Geun-Jeon Kim Dong-Il Sun Sang-Yeon Kim |
author_facet | Jooin Bang Hye Lim Park Ie Ryung Yoo Hyun-Il Shin Geun-Jeon Kim Dong-Il Sun Sang-Yeon Kim |
author_sort | Jooin Bang |
collection | DOAJ |
description | Although the prognosis of tonsillar cancer (human papillomavirus-positive oropharyngeal squamous cell carcinoma) is improving, disease control failure (distant metastasis) still occurs in some cases. We explored whether several <sup>18</sup>F-fluorodeoxyglucose (FDG) positron-emission tomography (PET) parameters can predict metastasis. We retrospectively reviewed the medical records of 55 patients with tonsil squamous cell carcinoma who underwent pretreatment <sup>18</sup>F-FDG positron-emission tomography/computed tomography (PET/CT) followed by primary surgery. During the follow-up period, systemic metastases were found in 7 of the 55 patients. The most common sites were the lungs (33%), bone (22%), brain/skull base (22%), small bowel (11%), and liver (11%). Pathologically, P53 mutation was less common in patients with systemic metastasis (41.7% vs. 14.3%, <i>p</i> = 0.054) than without systemic metastasis. In terms of PET parameters, the metabolic tumor volume (MTV<sub>2.5</sub>) and total lesion glycolysis (TLG<sub>2.5</sub>) values were lower in the primary tumor, and higher in the metastatic lymph nodes, of human papillomavirus (HPV)-positive compared to HPV-negative patients (all <i>p</i> < 0.05). The MTV<sub>2.5</sub>, TLG<sub>2.5</sub>, and tumor–to–liver uptake ratio were 36.07 ± 54.24 cm<sup>3</sup>, 183.46 ± 298.62, and 4.90 ± 2.77, respectively, in the systemic metastasis group, respectively; all of these values were higher than those of the patients without systemic metastasis (all <i>p</i> < 0.05). The MTV<sub>2.5</sub> value was significantly different between the groups even when the values for the primary tumor and metastatic lymph nodes were summed (53.53 ± 57.78 cm<sup>3</sup>, <i>p</i> = 0.036). The cut-off value, area under the curve (95% confidence interval), sensitivity, and specificity of MTV<sub>2.5</sub> for predicting systemic metastasis were 11.250 cm<sup>3</sup>, 0.584 (0.036–0.832), 0.571, and 0.565, respectively. The MTV<sub>2.5</sub> of metastatic lymph nodes and summed MTV<sub>2.5</sub> values of the primary tumor and metastatic lymph nodes were significantly higher in tonsillar cancer patients with than without systemic metastases. We suggest PET/CT scanning for pre-treatment cancer work-up and post-treatment surveillance to consider additional systemic therapy in patients with a high risk of disease control failure. |
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spelling | doaj.art-a91a5b07edc045a8ba0d93253634596d2023-11-24T13:48:40ZengMDPI AGCancers2072-66942022-12-011424624210.3390/cancers14246242Predictive Value of <sup>18</sup>F-Fluorodeoxyglucose Positron-Emission Tomography Metabolic and Volumetric Parameters for Systemic Metastasis in Tonsillar CancerJooin Bang0Hye Lim Park1Ie Ryung Yoo2Hyun-Il Shin3Geun-Jeon Kim4Dong-Il Sun5Sang-Yeon Kim6Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDivision of Nuclear Medicine, Department of Radiology, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDivision of Nuclear Medicine, Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaAlthough the prognosis of tonsillar cancer (human papillomavirus-positive oropharyngeal squamous cell carcinoma) is improving, disease control failure (distant metastasis) still occurs in some cases. We explored whether several <sup>18</sup>F-fluorodeoxyglucose (FDG) positron-emission tomography (PET) parameters can predict metastasis. We retrospectively reviewed the medical records of 55 patients with tonsil squamous cell carcinoma who underwent pretreatment <sup>18</sup>F-FDG positron-emission tomography/computed tomography (PET/CT) followed by primary surgery. During the follow-up period, systemic metastases were found in 7 of the 55 patients. The most common sites were the lungs (33%), bone (22%), brain/skull base (22%), small bowel (11%), and liver (11%). Pathologically, P53 mutation was less common in patients with systemic metastasis (41.7% vs. 14.3%, <i>p</i> = 0.054) than without systemic metastasis. In terms of PET parameters, the metabolic tumor volume (MTV<sub>2.5</sub>) and total lesion glycolysis (TLG<sub>2.5</sub>) values were lower in the primary tumor, and higher in the metastatic lymph nodes, of human papillomavirus (HPV)-positive compared to HPV-negative patients (all <i>p</i> < 0.05). The MTV<sub>2.5</sub>, TLG<sub>2.5</sub>, and tumor–to–liver uptake ratio were 36.07 ± 54.24 cm<sup>3</sup>, 183.46 ± 298.62, and 4.90 ± 2.77, respectively, in the systemic metastasis group, respectively; all of these values were higher than those of the patients without systemic metastasis (all <i>p</i> < 0.05). The MTV<sub>2.5</sub> value was significantly different between the groups even when the values for the primary tumor and metastatic lymph nodes were summed (53.53 ± 57.78 cm<sup>3</sup>, <i>p</i> = 0.036). The cut-off value, area under the curve (95% confidence interval), sensitivity, and specificity of MTV<sub>2.5</sub> for predicting systemic metastasis were 11.250 cm<sup>3</sup>, 0.584 (0.036–0.832), 0.571, and 0.565, respectively. The MTV<sub>2.5</sub> of metastatic lymph nodes and summed MTV<sub>2.5</sub> values of the primary tumor and metastatic lymph nodes were significantly higher in tonsillar cancer patients with than without systemic metastases. We suggest PET/CT scanning for pre-treatment cancer work-up and post-treatment surveillance to consider additional systemic therapy in patients with a high risk of disease control failure.https://www.mdpi.com/2072-6694/14/24/6242positron-emission tomographytonsillar neoplasmsneoplasm metastasismetabolic tumor volumepredictive value of tests |
spellingShingle | Jooin Bang Hye Lim Park Ie Ryung Yoo Hyun-Il Shin Geun-Jeon Kim Dong-Il Sun Sang-Yeon Kim Predictive Value of <sup>18</sup>F-Fluorodeoxyglucose Positron-Emission Tomography Metabolic and Volumetric Parameters for Systemic Metastasis in Tonsillar Cancer Cancers positron-emission tomography tonsillar neoplasms neoplasm metastasis metabolic tumor volume predictive value of tests |
title | Predictive Value of <sup>18</sup>F-Fluorodeoxyglucose Positron-Emission Tomography Metabolic and Volumetric Parameters for Systemic Metastasis in Tonsillar Cancer |
title_full | Predictive Value of <sup>18</sup>F-Fluorodeoxyglucose Positron-Emission Tomography Metabolic and Volumetric Parameters for Systemic Metastasis in Tonsillar Cancer |
title_fullStr | Predictive Value of <sup>18</sup>F-Fluorodeoxyglucose Positron-Emission Tomography Metabolic and Volumetric Parameters for Systemic Metastasis in Tonsillar Cancer |
title_full_unstemmed | Predictive Value of <sup>18</sup>F-Fluorodeoxyglucose Positron-Emission Tomography Metabolic and Volumetric Parameters for Systemic Metastasis in Tonsillar Cancer |
title_short | Predictive Value of <sup>18</sup>F-Fluorodeoxyglucose Positron-Emission Tomography Metabolic and Volumetric Parameters for Systemic Metastasis in Tonsillar Cancer |
title_sort | predictive value of sup 18 sup f fluorodeoxyglucose positron emission tomography metabolic and volumetric parameters for systemic metastasis in tonsillar cancer |
topic | positron-emission tomography tonsillar neoplasms neoplasm metastasis metabolic tumor volume predictive value of tests |
url | https://www.mdpi.com/2072-6694/14/24/6242 |
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