Prediction of prognosis using standardized uptake value of 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography for nasopharyngeal carcinomas

Purpose: To evaluate the prognostic significance of 2-[F-18]fluoro-2-deoxy-D-glucose positron emission tomography ([18F]FDG-PET) at diagnosis by calculating maximal standard uptake values (SUVmax) in patients with non-disseminated nasopharyngeal carcinoma (NPC) receiving concurrent chemo-radiotherapy (CCRT). Materials and methods: [18F]FDG-PET was performed in 41 patients with non-disseminated NPC scheduled to undergo platinum-based CCRT. [18F]FDG uptake by primary tumors and neck nodes was measured with the SUVmax. Results: Complete response occurred in all 41 patients. The ten patients who presented with any component of treatment failure had a significantly higher SUVmax than the remaining patients. The median SUVmax of all patients was 6.48 (range: 2.31-26.07). Patients having tumors with high [18F]FDG uptake (median or greater) had a significantly lower 3-year disease free survival (DFS) rate than patients with lower tumor [18F]FDG uptake (less than median) (51% vs 91%, P = 0.0070). Patients with an SUVmax below 8 had a higher DFS than patients with an SUVmax of 8 or greater. Conclusion: [18F]FDG uptake, as measured by the SUVmax, may predict DFS in CCRT-treated NPC. High [18F]FDG uptake may be useful for identifying patients requiring more aggressive treatment