FDG PET/CT and diffusion-weighted imaging of head and neck squamous cell carcinoma: Comparison of prognostic significance between primary tumor standardized uptake value and apparent diffusion coefficient

摘要

PURPOSE: To compare primary tumor F-fluorodeoxyglucose (FDG) maximum standardized uptake value (SUVmax) and diffusion-weighted imaging (DWI) apparent diffusion coefficient (ADC) obtained in the same patients with head and neck squamous cell carcinoma (HNSCC) to clarify the prognostic significance of both indexes. MATERIALS AND METHODS: The study population comprised 26 patients with HNSCC visible on both pretreatment FDG PET/CT and DWI. Correlation between SUVmax and ADC (b values; 0 and 800 seconds/mm) was analyzed by the Spearman's rank test. Disease-free survival (DFS) was calculated by the Kaplan-Meier method. Prognostic significance was assessed by the long-rank test and Cox proportional hazards analysis. RESULTS: SUVmax and ADC correlated significantly and negatively (ρ = -0.566, P = 0.005). High (>12.1) SUVmax (P < 0.001), low (≤0.88) ADC (P = 0.009), high (T3-4) T stage (P = 0.030), and high (N2-3) N stage (P = 0.007) were significant in predicting poor 2-year DFS. The accuracy for predicting disease events was 81% (21/26) for SUVmax (>12.1) and 73% (19/26) for ADC(≤0.88) without significant difference between them (P = 0.52). Disease event hazards ratios for significant unadjusted SUVmax (P = 0.015) and ADC (P = 0.039) remained significant when adjusted for other dichotomized clinical covariates (SUVmax; P = 0.009-0.039, ADC; P = 0.017-0.037) except SUVmax for ADC and ADC for SUVmax and T stage. CONCLUSION: These results suggest that pretreatment primary tumor SUVmax and ADC correlate significantly and negatively and both may have similar potential to predict DFS or disease events of HNSCC.