Abstract
Purpose: To explore the relationship between pathologic tumor volume and volume estimated from different tumor segmentation techniques on 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in oral cavity cancer. Materials and methods: Twenty-three patients with squamous cell carcinoma of the oral tongue had PET-CT scans before definitive surgery. Pathologic tumor volume was estimated from surgical specimens. Metabolic tumor volume (MTV) was defined from PET-CT scans as the volume of tumor above a given SUV threshold. Multiple SUV thresholds were explored including absolute SUV thresholds, relative SUV thresholds, and gradient-based techniques. Results: Multiple MTV's were associated with pathologic tumor volume; however the correlation was poor (R 2 range 0.29-0.58). The ideal SUV threshold, defined as the SUV that generates an MTV equal to pathologic tumor volume, was independently associated with maximum SUV (p = 0.0005) and tumor grade (p = 0.024). MTV defined as a function of maximum SUV and tumor grade improved the prediction of pathologic tumor volume (R 2 = 0.63). Conclusions: Common SUV thresholds fail to predict pathologic tumor volume in head and neck cancer. The optimal technique that allows for integration of PET-CT with radiation treatment planning remains to be defined. Future investigation should incorporate biomarkers such as tumor grade into definitions of MTV.
Original language | English (US) |
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Pages (from-to) | 356-361 |
Number of pages | 6 |
Journal | Radiotherapy and Oncology |
Volume | 101 |
Issue number | 3 |
DOIs | |
State | Published - Dec 2011 |
Externally published | Yes |
Keywords
- Head-and-neck cancer
- Metabolic tumor volume
- Positron emission tomography
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging
- Hematology