Surface-Colour Characteristics and Flow of Carbon Aminosilica Black Paste Using a Redispersible Polymer.

The surface colour of exposed concrete is one of the most obvious characteristics of quality because it is the first one to be seen. However, efflorescence generally changes the colour impression of the material surface and of the concrete facade as a whole. This study investigated the efflorescence of carbon aminosilica black (CASB) mortar and the effect of redispersible polymer powder (RPP) on the physical properties of CASB mortar. For this purpose, a flow test and colour evaluation was carried out on white Portland cement paste and mortar mixed with CASB by changing the proportion of RPP. RPP modifies the mechanical properties of the mortar by forming a polymer film in the cementitious matrix. The film prevents the transport of soluble calcium towards the surface and decreases efflorescence. As a result, the colour appearance of CASB mortar improved with increasing RPP content.

Modeling of Carbon Mortar Color Expression Using Artificial Neural Network.

Colored concrete uses pigments and white Portland cement (WPC) to perform decorative functions together with structural function. Pigments are used in permanent coloring of concrete with colors different from the natural color of the cement or the aggregates with mixing WPC. In this study, an artificial neural networks study was carried out to predict the color evaluation of black mortar using pigment and carbon black. A data set of a laboratory work, in which a total of 9 mortars were produced, was utilized in the Artificial Neural Networks (ANNs) study. The mortar mixture parameters were nine different pigment and carbon black ratios. Each mortar was measured at ten locations on the surface and averaged. Color can be evaluated by measurements of tristimulus values L* , a* and b* , represented in the chromatic space CIELAB. The L* value is a measure of luminosity (0 darkness), from completely opaque (0) to completely transparent (100); a* is a measure of redness (-a* greenness) and b* of yellowness (-b* blueness). ANN model is constructed, trained and tested using these data. The data used in the ANN model are arranged in a format of three input parameters that cover the pigment, carbon black and WPC and, an output parameter which is the color parameters of the black colored mortar. The results showed that ANN can be an alternative approach for the predicting the color parameters using mortar ingredients as input parameters.

Retrospective analysis of treatment outcomes for extranodal NK/T-cell lymphoma (ENKL), nasal type, stage I-IIE: single institute experience of combined modality treatment for early localized nasal extranodal NK/T-cell lymphoma (ENKL).

Extranodal natural killer/T-cell lymphoma (ENKL) is a very aggressive disease frequently involving the nasal cavity and upper aerodigestive tract. We retrospectively reviewed the treatment outcomes and treatment-associated complications of the patients with stage I-II early localized ENKL. A total of 24 patients were included. All patients were treated with combined chemoradiotherapy. Three, sixteen, and five patients were initially treated with radiation therapy, chemotherapy, and surgical procedures, respectively. Nine patients underwent hematopoietic stem cell transplantation (HSCT), and four patients administered immunotherapy with pegylated-interferon alpha. The mean observation time was 71.6 months (range, 29.7-183.6 months). Twenty patients achieved complete remission; thus, the overall response rate was 83.3 %. The 5-year overall survival (OS) and relapse-free survival (RFS) rates were 70.3 % and 62.2 %, respectively. In univariate analysis, HSCT was a significant prognostic indicator for OS and RFS. By combining HSCT, the 5-year OS and RFS rates were 100.0 % vs. 52.5 % (p = 0.018) and 88.9 % vs. 45.7 % (p = 0.045), respectively. Also, absence of B symptoms was a good prognostic factor for RFS, the 5-year RFS rate, 75.0 % vs. 25.0 % (p = 0.010), and B symptoms were significant for RFS in multivariate analysis (odds ratio = 7.4, confidence interval = 1.6~34.1, p = 0.011). However, a total of four cases of grade 3 toxicities were reported. Radiation dose range (≤4,500 vs. >4,500 cGy) was significantly correlated with late complications, as more severe complications occurred more frequently with a radiation dose >4,500 cGy (p = 0.026, in multivariate analysis). For more efficient treatment of ENKL, chemotherapy, HSCT, and/or immunotherapy can be combined with radiation therapy to prolong long-term survival and achieve good local control. Also, lower radiation dose could be administered to avoid severe late complications.

The relevance of serum carcinoembryonic antigen as an indicator of brain metastasis detection in advanced non-small cell lung cancer.

Although many biomarkers have emerged in non-small cell lung cancer (NSCLC), the predictive value of site-specific spread is not fully defined. We designed this study to determine if there is an association between serum biomarkers and brain metastasis in advanced NSCLC. We evaluated 227 eligible advanced NSCLC patients between May 2005 and March 2010. Patients who had been newly diagnosed with stage IV NSCLC but had not received treatment previously, and had available information on at least one of the following pretreatment serum biomarkers were enrolled: carcinoembryonic antigen (CEA), cytokeratin 19 fragments (CYFRA 21-1), cancer antigen 125 (CA 125), cancer antigen 19-9, and squamous cancer cell antigen. Whole body imaging studies and magnetic resonance imaging of the brain were reviewed, and the total number of metastatic regions was scored. Brain metastasis was detected in 66 (29.1%) patients. Although serum CEA, CYFRA 21-1, and CA 125 levels were significantly different between low total metastatic score group (score 1-3) and high total metastatic score group (score 4-7), only CEA level was significantly different between patients with brain metastasis and those without brain metastasis (p < 0.0001). The area under the receiver operating curve of serum CEA for the prediction of brain metastasis was 0.724 (p = 0.0001). The present study demonstrated that the pretreatment serum CEA level was significantly correlated with brain metastasis in advanced NSCLC. These findings suggested the possible role of CEA in the pathogenesis of brain invasion. More vigilant surveillance would be warranted in the high-risk group of patients with high serum CEA level and multiple synchronous metastasis.

Analysis the Compressive Strength of Flue Gas Desulfurization Gypsum Using Artificial Neural Network.

Flue Gas Desulfurization (FGD) gypsum is generated as a byproduct for the desulfurization process, using limestone powder as an absorber in the coal-fired power plants. The FGD gypsum is high in calcium sulfate concentrations and has few impurities. Its quality is not far behind compared to natural gypsum. An artificial neural networks (ANN) study was carried out to analyze the compressive strength of the FGD gypsum mortar. The mortar mixture parameters were eight partial FGD gypsum replacements. The compressive strengths of the cured specimens were measured. The ANN model was constructed, trained and tested using these data. The data used in the ANN model was arranged in a format of input parameters that cover the cement, FGD gypsum, age of samples, and an output parameter, which is compressive strength. This study showed that the ANN can be an approach for analyzing the compressive strength of the FGD gypsum mortar using the ingredients as input parameters.

Characteristics of Steam-Cured Carbon Amino Silica Black Mortar Using a Methyl Cellulose Polymer.

Along with the increase in the demand for existing colored concrete, the demand for secondary concrete products of various colors is also increasing. However, the initial surplus water in mortar causes the internal calcium component to leach out and contaminate the surface, and the hardening of concrete that contains pigment is generally slower than that of normal concrete. This study was to evaluate the physical properties of mortar colored by carbon amino silica black (CASB), using a methyl cellulose (MC) polymer to reduce surface efflorescence and increase early strength by means of steam curing. MC modifies the mechanical properties of mortar by forming a polymer film, which prevents the soluble calcium from migrating to the surface and reduces whitening in steam cured mortar. However, steam curing significantly decreased the strength with increasing MC content when CASB content was high.

Overlapped seed localization in seed implant brachytherapy.

A procedure for the determination of the location of prostate implant seeds that are wholly overlapped in a projection view has been developed. The procedure mainly consists of a series of image processing and an in-house developed localization software based on a three-film technique. To verify the efficacy of the procedure, a simulation phantom was built and nine sets of simulation were performed. For the assessment of the location of the seeds in the phantom, three images, one in anterior-posterior direction and two others in oblique angles, were acquired and a series of image processing was applied to the images for the removal of unnecessary background and the improvement of imaging quality. In this study, three types were considered; first, when two seeds were overlapped in one of projection images, second, more than three seeds were overlapped in one of projection images, and the third, all images contained wholly overlapped seeds. The developed software separates wholly overlapped seeds by calculating the distance between seeds in each film. This software can provide valuable information for establishing effective quality assurance in permanent prostate brachytherapy.

Dosimetric comparison between modulated arc therapy and static intensity modulated radiotherapy in thoracic esophageal cancer: a single institutional experience.

PURPOSE: The objective of this study was to compare dosimetric characteristics of three-dimensional conformal radiotherapy (3D-CRT) and two types of intensity-modulated radiotherapy (IMRT) which are step-and-shoot intensity modulated radiotherapy (s-IMRT) and modulated arc therapy (mARC) for thoracic esophageal cancer and analyze whether IMRT could reduce organ-at-risk (OAR) dose. MATERIALS AND METHODS: We performed 3D-CRT, s-IMRT, and mARC planning for ten patients with thoracic esophageal cancer. The dose-volume histogram for each plan was extracted and the mean dose and clinically significant parameters were analyzed. RESULTS: Analysis of target coverage showed that the conformity index (CI) and conformation number (CN) in mARC were superior to the other two plans (CI, p = 0.050; CN, p = 0.042). For the comparison of OAR, lung V5 was lowest in s-IMRT, followed by 3D-CRT, and mARC (p = 0.033). s-IMRT and mARC had lower values than 3D-CRT for heart V30 (p = 0.039), V40 (p = 0.040), and V50 (p = 0.032). CONCLUSION: Effective conservation of the lung and heart in thoracic esophageal cancer could be expected when using s-IMRT. The mARC was lower in lung V10, V20, and V30 than in 3D-CRT, but could not be proven superior in lung V5. In conclusion, low-dose exposure to the lung and heart were expected to be lower in s-IMRT, reducing complications such as radiation pneumonitis or heart-related toxicities.

Interobserver variation in target volume for salvage radiotherapy in recurrent prostate cancer patients after radical prostatectomy using CT versus combined CT and MRI: a multicenter study (KROG 13-11).

PURPOSE: To investigate interobserver variation in target volume delineations for prostate cancer salvage radiotherapy using planning computed tomography (CT) versus combined planning CT and magnetic resonance imaging (MRI). MATERIALS AND METHODS: Ten radiation oncologists independently delineated a target volume on the planning CT scans of five cases with different pathological status after radical prostatectomy. Two weeks later, this was repeated with the addition of planning MRI. The volumes obtained with CT only and combined CT and MRI were compared, and the effect of the addition of planning MRI on interobserver variability was assessed. RESULTS: There were large differences in clinical target volume (CTV) delineated by each observer, regardless of the addition of planning MRI (9.44-139.27 cm3 in CT only and 7.77-122.83 cm3 in CT plus MRI) and no significant differences in the mean and standard deviation of CTV. However, there were decreases in mean volume and standard deviation as a result of using the planning MRI. CONCLUSION: This study showed substantial interobserver variation in target volume delineation for salvage radiotherapy. The combination of planning MRI with CT tended to decrease the target volume and the variation.

Effects of static dosimetric leaf gap on MLC-based small-beam dose distribution for intensity-modulated radiosurgery.

The aim of the present study was to evaluate the effect of various specific dosimetric leaf gaps on the multileaf collimator (MLC)-based small-beam dose distribution. The dosimetric static leaf gap was determined by comparing the profiles of small MLC-based beams with those of small collimated fields (square fields of 1, 2, 3, and 4 cm). The results showed that an approximately 2-mm gap was optimal with the Millennium 120-leaf MLC (Varian Medical Systems, Palo Alto, CA) and a Varian 21EX 6-MV photon beam. We also investigated how much the leaf gap affects the planning results and the actual dose distribution. A doughnut-shaped planning target volume (PTV, 6.1 cm3) and inner organ at risk (OAR, 0.3 cm3) were delineated for delicate intensity-modulated radiosurgery test planning. The applied leaf gaps were 0, 1, and 2 mm. The measured dose distributions were compared with the dose distribution in the treatment planning system. The maximum dose differences at inside PTV, outside PTV, and inner OAR were, respectively, 22.3%, 20.2%, and 35.2% for the 0-mm leaf gap; 17.8%, 22.8%, and 30.8% for the 1-mm leaf gap; and 5.5%, 8.5%, and 6.3% for the 2-mm leaf gap. In a human head phantom (model 605: CIRS, Norfolk, VA) study, large dose differences of 1.3%-12.7% were noted for the measurements made using the MLC files generated by the three different leaf gaps. The planned results were similar, and measurements showed a large dose difference associated with the various leaf gaps. These results strongly suggest that plans generated by a commercial inverse planning system commissioned using general collimated field data will probably demonstrate discrepancies between the planned treatments and the measured results.

Use of Artificial Neural Network for the Simulation of Radon Emission Concentration of Granulated Blast Furnace Slag Mortar.

In this study, an artificial neural networks study was carried out to predict the quantity of radon of Granulated Blast Furnace Slag (GBFS) cement mortar. A data set of a laboratory work, in which a total of 3 mortars were produced, was utilized in the Artificial Neural Networks (ANNs) study. The mortar mixture parameters were three different GBFS ratios (0%, 20%, 40%). Measurement radon of moist cured specimens was measured at 3, 10, 30, 100, 365 days by sensing technology for continuous monitoring of indoor air quality (IAQ). ANN model is constructed, trained and tested using these data. The data used in the ANN model are arranged in a format of two input parameters that cover the cement, GBFS and age of samples and, an output parameter which is concentrations of radon emission of mortar. The results showed that ANN can be an alternative approach for the predicting the radon concentration of GBFS mortar using mortar ingredients as input parameters.

Development of deformable moving lung phantom to simulate respiratory motion in radiotherapy.

Radiation treatment requires high accuracy to protect healthy organs and destroy the tumor. However, tumors located near the diaphragm constantly move during treatment. Respiration-gated radiotherapy has significant potential for the improvement of the irradiation of tumor sites affected by respiratory motion, such as lung and liver tumors. To measure and minimize the effects of respiratory motion, a realistic deformable phantom is required for use as a gold standard. The purpose of this study was to develop and study the characteristics of a deformable moving lung (DML) phantom, such as simulation, tissue equivalence, and rate of deformation. The rate of change of the lung volume, target deformation, and respiratory signals were measured in this study; they were accurately measured using a realistic deformable phantom. The measured volume difference was 31%, which closely corresponds to the average difference in human respiration, and the target movement was - 30 to + 32mm. The measured signals accurately described human respiratory signals. This DML phantom would be useful for the estimation of deformable image registration and in respiration-gated radiotherapy. This study shows that the developed DML phantom can exactly simulate the patient׳s respiratory signal and it acts as a deformable 4-dimensional simulation of a patient׳s lung with sufficient volume change.

Therapy region monitoring based on PET using 478 keV single prompt gamma ray during BNCT: A Monte Carlo simulation study.

We confirmed the feasibility of using our proposed system to extract two different kinds of functional images from a positron emission tomography (PET) module by using an insertable collimator during boron neutron capture therapy (BNCT). Coincidence events from a tumor region that included boron particles were identified by a PET scanner before BNCT; subsequently, the prompt gamma ray events from the same tumor region were collected after exposure to an external neutron beam through an insertable collimator on the PET detector. Five tumor regions that contained boron particles and were located in the water phantom and in the BNCT system with the PET module were simulated with Monte Carlo simulation code. The acquired images were quantitatively analyzed. Based on the receiver operating characteristic (ROC) curves in the five boron regions, A, B, C, D, and E, the PET and single-photon images were 10.2%, 11.7%, 8.2% (center region), 12.6%, and 10.5%, respectively. We were able to acquire simultaneously PET and single prompt photon images for tumor regions monitoring by using an insertable collimator without any additional isotopes.

A Study on the Properties of Carbon Black Mortar Using Granulated Blast Furnace Slag and Polymer.

White Portland Cement (WPC) and inorganic pigment have been used in colored concrete, but there are some physical problems such as increases in efflorescence, and poor workability and low economics. The aim of this study was to investigate the effects of GBFS and polymer (methyl cellulose) on the physical properties of carbon black mortar. For this purpose, a flow test, compressive strength test and color evaluation and was carried out on cement mortar mixed with polymer by changing the proportion of cement and ratio of GBFS. The results show that the addition of polymer influences significantly the color value efficiency in colored mortar. This is due to the reduction of overall amount of micro pore. This polymer films prevent the transport of soluble calcium towards the surface, and decreases efflorescence. And the flow of colored mortar was increased in proportion to the addition rate of the GBFS. In addition the strength of colored mortars with GBFS at the long-term aged (after 28 days) was higher than that of the general WPC mortar, although its strength was developed slowly at the early ages.

M6P/IGF2R loss of heterozygosity in head and neck cancer associated with poor patient prognosis.

BACKGROUND: The mannose 6-phosphate/insulin-like growth factor 2 receptor (M6P/IGF2R) encodes for a multifunctional receptor involved in lysosomal enzyme trafficking, fetal organogenesis, cytotoxic T cell-induced apoptosis and tumor suppression. The purpose of this investigation was to determine if the M6P/IGF2R tumor suppressor gene is mutated in human head and neck cancer, and if allelic loss is associated with poor patient prognosis. METHODS: M6P/IGF2R loss of heterozygosity in locally advanced squamous cell carcinoma of the head and neck was assessed with six different gene-specific nucleotide polymorphisms. The patients studied were enrolled in a phase 3 trial of twice daily radiotherapy with or without concurrent chemotherapy; median follow-up for surviving patients is 76 months. RESULTS: M6P/IGF2R was polymorphic in 64% (56/87) of patients, and 54% (30/56) of the tumors in these informative patients had loss of heterozygosity. M6P/IGF2R loss of heterozygosity was associated with a significantly reduced 5 year relapse-free survival (23% vs. 69%, p = 0.02), locoregional control (34% vs. 75%, p = 0.03) and cause specific survival (29% vs. 75%, p = 0.02) in the patients treated with radiotherapy alone. Concomitant chemotherapy resulted in a better outcome when compared to radiotherapy alone only in those patients whose tumors had M6P/IGF2R loss of heterozygosity. CONCLUSIONS: This study provides the first evidence that M6P/IGF2R loss of heterozygosity predicts for poor therapeutic outcome in patients treated with radiotherapy alone. Our findings also indicate that head and neck cancer patients with M6P/IGF2R allelic loss benefit most from concurrent chemotherapy.

Detrimental effects of cement mortar and fly ash mortar on asthma progression.

Currently, concrete additive materials are used worldwide to improve properties of concrete production and to reduce the total cost of the materials used in the concrete. However, the effects of exposure to various gases emitted from mortar mixed with additive materials are poorly understood. To evaluate the pattern of gas emission from cement mortar and additives, the emission levels of gas including ammonia (NH3) and volatile organic compounds (VOCs) were measured from two different mortar types, Ordinary Portland Cement (OPC), and OPC with fly ash on various time points after manufacture. On days 1, 3, 10 and 30 after manufacture, moderate concentrations of NH3 (4, 9, 12 and 5 ppm) were measured in OPC mortar (24h, 150 mm × 150 mm × 50 mm), whereas higher concentrations of NH3 (73, 55, 20 and 5 ppm) were measured in OPC mortar with fly ash (24h, 150 mm × 150 mm × 50 mm). Furthermore, the concentration of VOCs was more than 10 ppm on 1, 3, and 10 days of age in OPC and OPC with fly ash mortars. To examine the mortars' allergic effects on the respiratory system, mice were sensitized with ovalbumin (OVA) and divided into four groups: normal, asthma control, OPC mortar and OPC mortar with fly ash. The mice were housed in corresponding group cage for 10 days with OVA challenges to induce asthma. Histopathologically, increased infiltration of lymphocytes was observed in the lung perivascular area of mice housed in OPC mortar and OPC mortar with fly ash cages compared to lungs of asthma control mice. Moreover, severe bronchial lumen obstruction and increased hypertrophy of bronchial epithelial cells (p<0.05) were observed in the OPC mortar with fly ash group compared to OPC mortar or asthma control groups. Lungs of the two mortar groups generally expressed higher levels of genes related with asthma, including IL-4, eotaxin and epidermal growth factor (EGF) compared to lungs of asthma control mice. Additionally, the OPC mortar with fly ash group showed higher expression of IL-5, 13 and monocyte chemoattractant protein-1 (MCP-1) compared to the asthma control group. These results indicate that OPC mortar and OPC mortar with fly ash might exacerbate asthma.

Differential expression of MicroRNAs in patients with glioblastoma after concomitant chemoradiotherapy.

Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor, and notorious for resistance to chemoradiotherapy. MicroRNAs (miRNAs) are significantly involved in the initiation and progression of numerous cancers; however, the role of miRNAs in recurrence of tumors remains unknown. Here we tried to identify novel miRNAs that are differentially expressed in recurrent GBM. Tissue samples were obtained from patients with primary and recurrent GBM treated with chemoradiotherapy, and the expression changes of miRNAs were measured by microarray. A total of 318 miRNAs were expressed in the GBM patients. The expression of 43 miRNAs were significantly altered at least 2-fold in primary and recurrent GBMs. Bioinformatic analysis revealed that the differentially expressed miRNAs and their putative target genes were mainly involved in cell death, cellular development, and cellular growth and proliferation, which are the key regulators for stem cells. Pathway analysis supported that the miRNAs may regulate signaling associated with induction and maintenance of cancer and stem cell, such as p53, ErbB1, Notch, Wnt, and TGF-ß signaling pathways. These data suggest that, in recurrent GBM, growth factor and anti-apoptotic signalings for cancer cell growth and proliferation are regulated by miRNAs. Our findings will aid future research in understanding the pathophysiology of recurrent GBM and identifying diagnostic markers and/or therapeutic targets for recurrence of GBM.

The role of postoperative pelvic radiation in stage IV rectal cancer after resection of primary tumor.

PURPOSE: To evaluate the effect of pelvic radiotherapy (RT) in patients with stage IV rectal cancer treated with resection of primary tumor with or without metastasectomy. MATERIALS AND METHODS: Medical records of 112 patients with stage IV rectal cancer treated with resection of primary tumor between 1990 and 2011 were retrospectively reviewed. Fifty-nine patients received synchronous or staged metastasectomy whereas fifty-three patients did not. Twenty-six patients received pelvic radiotherapy. RESULTS: Median overall survival (OS), locoregional recurrence-free survival (LRFS), and progression-free survival (PFS) of all patients was 27, 70, and 11 months, respectively. Pathologic T (pT), N (pN) classification and complete metastasectomy were statistically significant factors in OS (p = 0.040, 0.020, and 0.002, respectively). RT did not improve OS or LRFS. There were no significant factors in LRFS. pT and pN classification were also significant prognostic factors in PFS (p = 0.010 and p = 0.033, respectively). In the subgroup analysis, RT improved LRFS in patients with pT4 disease (p = 0.026). The locoregional failure rate of the RT group and the non-RT group were 23.1% and 33.7%, showing no difference in the failure pattern of both groups (p = 0.260). CONCLUSION: Postoperative pelvic RT did not improve LRFS of all metastatic rectal cancer patients; however, it can be recommended to patients with pT4 disease. A complete resection of metastatic masses should be performed if possible.

Radiation-induced brain injury: retrospective analysis of twelve pathologically proven cases.

PURPOSE: This study was designed to determine the influencing factors and clinical course of pathologically proven cases of radiation-induced brain injury (RIBI). MATERIALS AND METHODS: The pathologic records of twelve patients were reviewed; these patients underwent surgery following radiotherapy due to disease progression found by follow-up imaging. However, they were finally diagnosed with RIBI. All patients had been treated with 3-dimensional conventional fractionated radiotherapy and/or radiosurgery for primary or metastatic brain tumors with or without chemotherapy. The histological distribution was as follows: two falx meningioma, six glioblastoma multiform (GBM), two anaplastic oligodendroglioma, one low grade oligodendroglioma, and one small cell lung cancer with brain metastasis. RESULTS: Radiation necrosis was noted in eight patients and the remaining four were diagnosed with radiation change. Gender (p = 0.061) and biologically equivalent dose (BED)(3) (p = 0.084) were the only marginally influencing factors of radiation necrosis. Median time to RIBI was 7.3 months (range, 0.5 to 61 months). Three prolonged survivors with GBM were observed. In the subgroup analysis of high grade gliomas, RIBI that developed <6 months after radiotherapy was associated with inferior overall survival rates compared to cases of RIBI that occurred ≥6 months (p = 0.085). CONCLUSION: Our study demonstrated that RIBI could occur in early periods after conventional fractionated brain radiotherapy within normal tolerable dose ranges. Studies with a larger number of patients are required to identify the strong influencing factors for RIBI development.

FDG-PET/CT as prognostic factor and surveillance tool for postoperative radiation recurrence in locally advanced head and neck cancer.

PURPOSE: To evaluate the prognostic value of metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) on initial positron emission tomography-computed tomography (PET-CT) and investigate the clinical value of SUVmax for early detection of locoregional recurrent disease after postoperative radiotherapy in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: A total of 100 patients with locally advanced HNSCC received primary tumor excision and neck dissection followed by adjuvant radiotherapy with or without chemotherapy. The MTV and SUVmax were measured from primary sites and neck nodes. The prognostic value of MTV and SUVmax were assessed using initial staging PET/CT (study A). Follow-up PET/CT scan available after postoperative concurrent chemoradiotherapy or radiotherapy were evaluated for the SUVmax value and correlated with locoregional recurrence (study B). A receiver operating characteristic (ROC) curve analysis was used to define a threshold value of SUVmax with the highest accuracy for recurrent disease assessment. RESULTS: High MTV (>41 mL) is negative prognostic factor for disease free survival (p = 0.041). Postradiation SUVmax was significantly correlated with locoregional recurrence (hazard ratio, 1.812; 95% confidence interval, 1.361 to 2.413; p < 0.001). A cut-off value of 5.38 from follow-up PET/CT was identified as having maximal accuracy for detecting locoregional recurrence by ROC analysis. CONCLUSION: MTV at staging work-up was significantly associated with disease free survival. The SUVmax value from follow-up PET/CT showed high diagnostic accuracy for the detection of locoregional recurrence in postoperatively irradiated HNSCC.