Objective: We prospectively compared the diagnostic value of PET/computed tomography (CT) findings using the tracers 4′-[methyl-11C]-thiothymidine (11C-4DST) and 2-deoxy-2-18F-fluoro-D-glucose (18F-FDG) in patients with head and neck squamous cell carcinoma (HNSCC).
Patients and methods: Thirty-eight patients with advanced HNSCC underwent 11C-4DST PET/CT and 18F-FDG PET/CT before treatment. Maximum standardized uptake values (SUVmax) were measured for both PET/CT studies; in addition, total lesion glycolysis (TLG) of 18F-FDG PET/CT and total lesion proliferation (TLP) of 11C-4DST PET/CT were measured. Absolute TLG and TLP values as well as values with various SUV thresholds were measured. All patients were followed up for 13.5±7.5 months (mean±SD) to monitor recurrence.
Results: A statistically significant correlation was observed between the primary tumor SUVmax for 11C-4DST PET/CT and 18F-FDG PET/CT (r=0.46, P<0.01). TLP values with SUV thresholds strongly correlated with TLG values relative to the same thresholds (r=0.60–0.92, P<0.001). Nine of the 38 patients with post-treatment recurrence were identified. Receiver operating characteristic curves for TLG3.0 and TLP2.5 showed the highest prognostic ability for recurrence; the sensitivity and specificity of TLG3.0 were 89 and 72%, respectively, and the sensitivity and specificity of TLP2.5 were 89 and 55%, respectively.
Conclusion: In patients with advanced HNSCC, the TLP of 11C-4DST PET/CT strongly correlated with the TLG of 18F-FDG PET/CT. Although there were no large differences between these values, the receiver operating characteristic curves of the absolute TLG had slightly better prognostic ability for recurrence.
aDepartment of Radiology, Division of Nuclear Medicine, National Center for Global Health and Medicine
bDepartment of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine
cResearch Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology
dDepartment of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
Correspondence to Kimiteru Ito, MD, PhD, Department of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan Tel: +81 3 3964 1141; fax: +81 3 3064 1982; e-mail: firstname.lastname@example.org
Received June 5, 2014
Received in revised form September 6, 2014
Accepted October 2, 2014