Correlation between metabolic tumor volume and pathologic tumor volume in squamous cell carcinoma of the oral cavity

James D. Murphy, Karen M. Chisholm, Megan E Daly, Ellen A. Wiegner, Daniel Truong, Andrei Iagaru, Peter G. Maxim, Billy W. Loo, Edward E. Graves, Michael J. Kaplan, Christina Kong, Quynh Thu Le

Research output: Contribution to journalArticle

35 Scopus citations


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 languageEnglish (US)
Pages (from-to)356-361
Number of pages6
JournalRadiotherapy and Oncology
Issue number3
StatePublished - Dec 2011
Externally publishedYes



  • Head-and-neck cancer
  • Metabolic tumor volume
  • Positron emission tomography

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Hematology

Cite this

Murphy, J. D., Chisholm, K. M., Daly, M. E., Wiegner, E. A., Truong, D., Iagaru, A., Maxim, P. G., Loo, B. W., Graves, E. E., Kaplan, M. J., Kong, C., & Le, Q. T. (2011). Correlation between metabolic tumor volume and pathologic tumor volume in squamous cell carcinoma of the oral cavity. Radiotherapy and Oncology, 101(3), 356-361.