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. 2022 Sep;279(9):4577-4586.
doi: 10.1007/s00405-022-07401-y. Epub 2022 May 2.

Utility and limitations of metabolic parameters in head and neck cancer: finding a practical segmentation method

Jefferson Rijo-Cedeño  1   2 , Jorge Mucientes  3 , Ithzel María Villarreal  4 , Ana Royuela  5 , Patricia García Vicente  6 , José Ramón García-Berrocal  6   7
Affiliations

Utility and limitations of metabolic parameters in head and neck cancer: finding a practical segmentation method

Jefferson Rijo-Cedeño et al. Eur Arch Otorhinolaryngol. 2022 Sep.

Abstract

Purpose: Although metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have shown good prognostic value in head and neck cancer (HNC), there are still many issues to resolve before their potential application in standard clinical practice. The purpose of this study was to compare the discrimination ability of two relevant segmentation methods in HNC and to evaluate the potential benefit of adding lymph nodes' metabolism (LNM) to the measurements.

Methods: We retrospectively analyzed a recently published database of 62 patients with HNC treated with chemoradiotherapy. MTV and TLG were measured using an absolute threshold of SUV2.5. Comparison analysis with previously published background-level threshold (BLT) results was done through Concordance index (C-index) in eight prognostic models.

Results: BLT obtained better C-index values in five out of the eight models. The addition of LNM improved C-index values in six of the prognostic models.

Conclusion: We found a potential benefit in adding LNM to the main tumor measurements, as well as in using a BLT for MTV segmentation compared to the most commonly used SUV2.5 threshold. Despite its limitations, this study suggests a practical and simple manner to use these parameters in standard clinical practice, aiming to help elaborate a general consensus.

Keywords: Cancer; Head and neck; MTV; PET; TLG.

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Conflict of interest statement

The authors declare no conflicts of interest that could be perceived as prejudicing the impartiality of the research reported. This study did not receive any financial support and it has been approved by the Institutional Ethics Committee of Puerta de Hierro University Hospital. Because of the retrospective design of this study, informed consent was waived.

Figures

Fig. 1
Fig. 1
Kaplan–Meier’s curves for DFS and OS using the MTV and TLG dichotomized models. A, Curves for OS and a cutoff of 60 ml of MTV. B, Curves for OS and a cutoff of 284 g of TLG; C, curves for DFS and a cutoff of 60 ml of MTV. D, Curves for DFS and a cutoff of 284 g of TLG. MTV metabolic tumor volume, TLG total lesion glycolysis, ml milliliter, g gram
See this image and copyright information in PMC

References

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