Importancia pronóstica de las distancias normalizadas entre el punto de captación máxima estandarizado del radiotrazador y el centro tumoral en la PET/TC con 18F-FDG en el carcinoma de células escamosas de cabeza y cuello

Abstract

Objective

The maximum ¹⁸F-FDG uptake of a cancer lesion has been found to relocate from the center to the periphery during progression. This behavior proposes that the normalized distances from the hotspot of radiotracer uptake to the tumor centroid (NHOC) and to the tumor perimeter (NHOP) could serve as novel geometric PET parameters indicative of tumor aggressiveness. This study aimed to explore the prognostic relevance of NHOC and NHOP in ¹⁸F-FDG PET/CT for predicting the response to concurrent chemoradiotherapy (CCRT) and progression-free survival (PFS) in patients with head and neck squamous cell carcinoma.

Materials and methods

We retrospectively reviewed 116 head and neck squamous cell carcinoma patients who received CCRT and were assessed with pre-treatment (PET1) and 3 months post-treatment PET/CT (PET2). Along with conventional PET parameters, NHOC and NHOP for primary tumors on PET1 and the percent changes in NHOC and NHOP between PET1 and PET2 were measured.

Results

Of all the PET1 parameters assessed, NHOC was the most effective in predicting the CCRT response, achieving an area under the receiver operating characteristic curve of 0.645. In multivariate logistic regression and survival analysis, NHOC identified as an independent predictor for both complete metabolic response (p = 0.028) and PFS (p = 0.006). In a subgroup of 46 patients exhibiting residual primary tumors on PET2, both the percent changes in NHOC (p = 0.048) and NHOP (p = 0.041) were significantly associated with PFS.

Conclusions

NHOC and the percent changes in NHOC and NHOP following CCRT may serve as effective ¹⁸F-FDG PET/CT parameters for predicting clinical outcomes in head and neck squamous cell carcinoma patients.