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 journalArticlepeer-review

36 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


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