Prediction of prognosis using standardized uptake value of 2-[(18)F] 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 ([(18)F]FDG-PET) at diagnosis by calculating maximal standard uptake values (SUV(max)) in patients with non-disseminated nasopharyngeal carcinoma (NPC) receiving concurrent chemo-radiotherapy (CCRT).

MATERIALS AND METHODS: [(18)F]FDG-PET was performed in 41 patients with non-disseminated NPC scheduled to undergo platinum-based CCRT. [(18)F]FDG uptake by primary tumors and neck nodes was measured with the SUV(max).

RESULTS: Complete response occurred in all 41 patients. The ten patients who presented with any component of treatment failure had a significantly higher SUV(max) than the remaining patients. The median SUV(max) of all patients was 6.48 (range: 2.31-26.07). Patients having tumors with high [(18)F]FDG uptake (median or greater) had a significantly lower 3-year disease free survival (DFS) rate than patients with lower tumor [(18)F]FDG uptake (less than median) (51% vs 91%, P=0.0070). Patients with an SUV(max) below 8 had a higher DFS than patients with an SUV(max) of 8 or greater.

CONCLUSION: [(18)F]FDG uptake, as measured by the SUV(max), may predict DFS in CCRT-treated NPC. High [(18)F]FDG uptake may be useful for identifying patients requiring more aggressive treatment.