Generation of synthetic PET/MR fusion images from MR images using a combination of generative adversarial networks and conditional denoising diffusion probabilistic models based on simultaneous 18F-FDG PET/MR image data of pyogenic spondylodiscitis.

BACKGROUND CONTEXT: Cross-modality image generation from magnetic resonance (MR) to positron emission tomography (PET) using the generative model can be expected to have complementary effects by addressing the limitations and maximizing the advantages inherent in each modality. PURPOSE: This study aims to generate synthetic PET/MR fusion images from MR images using a combination of generative adversarial networks (GANs) and conditional denoising diffusion probabilistic models (cDDPMs) based on simultaneous 18F-fluorodeoxyglucose (18F-FDG) PET/MR image data. STUDY DESIGN: Retrospective study with prospectively collected clinical and radiological data. PATIENT SAMPLE: This study included 94 patients (60 men and 34 women) with thoraco-lumbar pyogenic spondylodiscitis (PSD) from February 2017 to January 2020 in a single tertiary institution. OUTCOME MEASURES: Quantitative and qualitative image similarity were analyzed between the real and synthetic PET/ T2-weighted fat saturation MR (T2FS) fusion images on the test data set. METHODS: We used paired spinal sagittal T2FS and PET/T2FS fusion images of simultaneous 18F-FDG PET/MR imaging examination in patients with PSD, which were employed to generate synthetic PET/T2FS fusion images from T2FS images using a combination of Pix2Pix (U-Net generator + Least Squares GANs discriminator) and cDDPMs algorithms. In the analyses of image similarity between the real and synthetic PET/T2FS fusion images, we adopted the values of mean peak signal to noise ratio (PSNR), mean structural similarity measurement (SSIM), mean absolute error (MAE), and mean squared error (MSE) for quantitative analysis, while the discrimination accuracy by three spine surgeons was applied for qualitative analysis. RESULTS: Total of 2,082 pairs of T2FS and PET/T2FS fusion images were obtained from 172 examinations on 94 patients, which were randomly assigned to training, validation, and test data sets in 8:1:1 ratio (1664, 209, and 209 pairs). The quantitative analysis revealed PSNR of 30.634 ± 3.437, SSIM of 0.910 ± 0.067, MAE of 0.017 ± 0.008, and MSE of 0.001 ± 0.001, respectively. The values of PSNR, MAE, and MSE significantly decreased as FDG uptake increased in real PET/T2FS fusion image, with no significant correlation on SSIM. In the qualitative analysis, the overall discrimination accuracy between real and synthetic PET/T2FS fusion images was 47.4%. CONCLUSIONS: The combination of Pix2Pix and cDDPMs demonstrated the potential for cross-modal image generation from MR to PET images, with reliable quantitative and qualitative image similarities.

Prediction of motor outcome based on brain perfusion single photon emission computed tomography in corona radiata infarct.

BACKGROUND: There is limited information on brain perfusion single-photon emission computed tomography (SPECT) findings related to motor outcomes in patients with stroke. We aimed to investigate whether brain SPECT can be used to determine motor outcomes after corona radiata infarction. METHODS: Eighty-nine patients were recruited in this study. Brain SPECT and diffusion tensor tractography (DTT) were conducted to evaluate the state of the corticospinal tract (CST) within 7-30 days of corona radiata infarct. Motor outcome was measured 6 months after infarct onset and was evaluated using the modified Brunnstrom classification (MBC) and functional ambulation category (FAC) for motor function of the upper and lower extremities, respectively. The presence of hypoperfusion on brain SPECT was evaluated in the frontal lobe, temporal lobe, parietal lobe, basal ganglia, thalamus, and cerebellum on both the ipsilesional and contralesional sides. Statistical analysis was performed using multivariate logistic regression, comparing patients in which CST was spared versus interrupted. RESULTS: Hypoperfusion in the contralesional cerebellum was indicative of poor recovery in both the upper and lower extremities after corona radiata infarction when the CST was interrupted. Additionally, when the CST was preserved, hypoperfusion in the ipsilesional thalamus was indicative of poor recovery of the lower extremities. CONCLUSION: Brain SPECT evaluation was shown to be a useful tool for predicting motor outcomes in patients with corona radiata infarcts.

Brain FDG PET for visualizing the relation between impaired lung function and cognitive decline in lung cancer: a preliminary study.

OBJECTIVE: Impaired lung function is associated with an increased risk for cognitive decline. F-18 fluorodeoxyglucose (FDG) PET is a well-known neurodegenerative biomarker for dementia. We investigated the association between lung and brain function using FDG PET in patients with lung cancer. METHODS: A random sub-sample of 102 patients with lung cancer and without a self-reported history of neuropsychiatric disorders were recruited and underwent both lung function tests and FDG PET scans before treatment. Lung function was analyzed as the percentage predicted value (% pred) of forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1). FDG uptake was measured as standardized uptake values (SUVs) in the frontal, parietal, temporal, and occipital cortices and cognition-related regions. Regional SUV ratios (SUVRs) were calculated by dividing the SUV in each region by the whole-brain SUV and were then evaluated against lung function indices and clinical variables. RESULTS: After excluding five patients with brain metastases, 97 patients were included in the final analysis (mean age, 67.7 ± 10.3 years). Mean FVC and mean FEV1 were 80.0% ± 15.4% and 77.6% ± 17.8%, respectively. Both FVC and FEV1 were positively correlated with SUVRs in all brain regions after adjusting the data for clinical variables. The degree of decrease in SUVRs related to lung function was not significantly different between cognition-related regions and other regions. CONCLUSION: Impaired lung function was associated with decreased glucose metabolism in all regions of the brain, indicating that cognitive decline related to decreased glucose metabolism may be due to reduced perfusion.

Assessment of Therapeutic Responses Using a Deep Neural Network Based on 18F-FDG PET and Blood Inflammatory Markers in Pyogenic Vertebral Osteomyelitis.

Background and Objectives: This study investigated the usefulness of deep neural network (DNN) models based on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and blood inflammatory markers to assess the therapeutic response in pyogenic vertebral osteomyelitis (PVO). Materials and Methods: This was a retrospective study with prospectively collected data. Seventy-four patients diagnosed with PVO underwent clinical assessment for therapeutic responses based on clinical features during antibiotic therapy. The decisions of the clinical assessment were confirmed as 'Cured' or 'Non-cured'. FDG-PETs were conducted concomitantly regardless of the decision at each clinical assessment. We developed DNN models depending on the use of attributes, including C-reactive protein (CRP), erythrocyte sedimentation ratio (ESR), and maximum standardized FDG uptake values of PVO lesions (SUVmax), and we compared their performances to predict PVO remission. Results: The 126 decisions (80 'Cured' and 46 'Non-cured' patients) were randomly assigned with training and test sets (7:3). We trained DNN models using a training set and evaluated their performances for a test set. DNN model 1 had an accuracy of 76.3% and an area under the receiver operating characteristic curve (AUC) of 0.768 [95% confidence interval, 0.625-0.910] using CRP and ESR, and these values were 79% and 0.804 [0.674-0.933] for DNN model 2 using ESR and SUVmax, 86.8% and 0.851 [0.726-0.976] for DNN model 3 using CRP and SUVmax, and 89.5% and 0.902 [0.804-0.999] for DNN model 4 using ESR, CRP, and SUVmax, respectively. Conclusions: The DNN models using SUVmax showed better performances when predicting the remission of PVO compared to CRP and ESR. The best performance was obtained in the DNN model using all attributes, including CRP, ESR, and SUVmax, which may be helpful for predicting the accurate remission of PVO.

FDG PET/MRI of Acute Myocarditis After mRNA COVID-19 Vaccination.

ABSTRACT: A 22-year-old man visited the emergency department with chest pain. He had received a second dose of the coronavirus disease 2019 (COVID-19) mRNA (Moderna) vaccine 5 days prior. 18F-FDG PET/MR revealed a focal FDG uptake and late gadolinium enhancement on the basal posterolateral wall of the left ventricle. Myocarditis after a COVID-19 vaccination has been reported predominantly after the second dose of mRNA vaccines in young men. This was a case of acute focal myocarditis after a COVID-19 mRNA vaccination, which was well-visualized by FDG PET/MRI.

The new perspective of PET/CT for axillary nodal staging in early breast cancer patients according to ACOSOG Z0011 trial PET/CT axillary staging according to Z0011.

OBJECTIVE: Post Z0011 trial, axillary lymph node dissections (ALNDs) can be performed in patients with ≥3 positive axillary lymph nodes (ALNs). We investigated the diagnostic performance of 18F-fluorodeoxyglucose PET/computed tomography (FDG PET/CT) to predict ≥3 metastasis [high nodal burden (HNB)]. METHODS: We retrospectively analyzed preoperative FDG PET/CT from January 2010 to June 2012. Patients had clinical T1-2N0 primary invasive breast cancer and underwent breast-conserving surgery with sentinel lymph node biopsy ± ALND. All suspicious ALNs were counted considering FDG-avidity with morphologic changes. Images were considered positive if the axillary basin took up more FDG than the surrounding tissue. On CT, abnormal ALNs were round/ovoid or had cortical thickening with contrast enhancement. PET/CT results were compared with the histology and follow-up findings. RESULTS: In total, 221 females with 224 axillae were enrolled; 161 had negative, 53 had 1-2 metastasis [low nodal burden (LNB)] and 10 had HNB. The sensitivity, specificity, negative predictive value and positive predictive value of PET/CT for HNB were 70, 100, 98.6 and 100%, respectively. There was a correlation between the number of suspicious ALNs on PET/CT and the metastatic nodes on final histology. There were no significant differences in age, tumor size and FDG-avidity between patients with negative or LNB and HNB. During follow-up, 25 patients had a recurrence. The three false-negative patients did not show recurrence. CONCLUSION: Preoperative PET/CT predicts HNB with high accuracy and is useful for evaluating clinical T1-2N0 invasive breast cancer.

Comparison of perfusion 18F-FP-CIT PET and 99mTc-ECD SPECT in parkinsonian disorders.

ABSTRACT: Early and accurate identification of various conditions that can cause parkinsonian symptoms is important for determining treatment policies. Currently dopamine transporter (DAT) imaging using FP-CIT, glucose metabolism imaging using fluorodeoxyglucose, cerebral blood flow image using ethyl cysteinate dimer (ECD), and others are used for differentiation. However, the use of multiple modalities is inconvenient and costly. In the present retrospective study, we evaluated the correlation between regional brain uptake ratios (URs) in perfusion FP-CIT PET and ECD SPECT images.Twenty patients with Parkinson's symptoms underwent perfusion DAT positron emission tomography (18F-FP-CIT PET/CT) and cerebral blood flow tomography (99mTc-ECD SPECT) within a 2-week period. Perfusion 18F-FP-CIT PET/CT and 99mTc-ECD SPECT URs of 19 brain regions (bilateral frontal, temporal, parietal and occipital lobes, bilateral caudate nucleus, bilateral putamen, bilateral insula, bilateral cingulate gyrus, bilateral thalamus, and brainstem) were directly compared and correlations were analyzed.Average 18F-FP-CIT PET/CT regional perfusion URs were higher than 99mTc-ECD SPECT URs. Uptake ratios were well correlated in all 19 regions (except right putamen), and especially in dopamine poor regions (cerebral cortex). In left putamen, URs were significantly correlated, but the correlation coefficient was lower than those of other regions.A single tracer dual phase N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane test seems to be helpful for differential diagnosis of parkinsonian disorders. Large-scale, longitudinal studies on complementary diseases with parkinsonian patterns are required to investigate differences in correlations between perfusion 18F-FP-CIT PET/CT and 99mTc-ECD SPECT over time.

Validity of Clinical Assessment Using Clinical Symptoms and C-Reactive Protein for Therapeutic Response in Pyogenic Vertebral Osteomyelitis: Analysis Based on 18F-FDG-PET.

Backgroundand objectives: The clinical assessment of therapeutic response in pyogenic vertebral osteomyelitis (PVO) has been usually performed based on the changes of clinical symptoms and blood inflammatory markers. Recently, 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) has emerged as an alternative independent method. We analyzed the validity of the clinical assessment for detecting residual PVO based on 18F-FDG-PET. Materials and Methods: This study was conducted with 53 patients confirmed as lumbar PVO under retrospective design. All patients underwent clinical assessment using clinical symptoms and C-reactive protein (CRP) for therapeutic response after parenteral antibiotic therapy, which led to the decision of placement in the uncontrolled (group UC) or controlled (group C) group. The validity of clinical assessment was analyzed based on the cut-off values of FDG uptake for detecting residual PVO as references, which are already established in the previous literature. Results: The mean duration of parenteral antibiotic therapy and recurrence rate were 42.19 ± 15.84 (21-89) days and 9.4% (5/53), respectively. 18F-FDG-PETs were performed at 80 rounds of clinical assessment on 37.40 ± 13.15 (21-83) days of parenteral antibiotic therapy and divided: 31 into group UC and 49 into group C, according to the decisions of clinical assessment. Based on the cut-off values of FDG uptake, clinical assessment showed 48.4-58.1% of false positive for residual PVO in group UC. However, 18F-FDG-PET showed 8.2% (4/49) of false negative for residual PVO in group C, which led to recurrences. Conclusions: Clinical assessment using clinical symptoms and CRP for evaluating therapeutic response in PVO is still a useful method in terms of similar recurrence rate compared to 18F-FDG-PET. However, the high rate of false positive for residual PVO can prolong the use of unnecessary antibiotics and overall treatment period.

Clinical and Radiological Features Predicting Intervertebral Autofusion after Successful Antibiotic Therapy in Pyogenic Vertebral Osteomyelitis.

BACKGROUND: Pyogenic vertebral osteomyelitis (PVO) is a bacterial infection involving the intervertebral disc, vertebral body, and paravertebral soft tissues. Damaged intervertebral structure is a major cause of persistent back pain even after successful antibiotic therapy, which can be improved by achieving autofusion or via additional surgical fixation. In this study, we analyzed the clinical and radiological features predicting intervertebral autofusion after successful antibiotic therapy in lumbar PVO. METHODS: This study was retrospectively conducted with 32 patients (20 men and 12 women) diagnosed with lumbar PVO that was completely cured with no recurrences after antibiotic therapy. They were divided into two groups with (group A, n = 18) and without (group B, n = 14) intervertebral autofusion at six-month follow-up. Differences in back pain, blood inflammatory markers, and radiological features of PVO on simultaneous 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (18F-FDG-PET/MRI) of the intervertebral structure between the two groups were analyzed. RESULTS: The mean duration of antibiotic therapy was 41.44 ± 14.21 (21-89) days. Group A showed a statistically higher erythrocyte sedimentation ratio (ESR; 59.28 ± 32.33 vs. 33.93 ± 18.76 mm/h, p = 0.014; normal range of ESR < 25), maximum standardized 18F-FDG uptake (SUVmax; 5.56 ± 1.86 vs. 3.98 ± 1.40, p = 0.013), and sustained extensive edematous changes on T2-weighted fat saturation (T2FS) MRI (p = 0.015) immediately after successful antibiotic therapy. However, no significant differences were observed in back pain, C-reactive protein, or the distribution of 18F-FDG uptake/contrast enhancement on 18F-FDG-PET/MRI (p > 0.05). CONCLUSIONS: Higher ESR and SUVmax of the intervertebral structure and sustained extensive edematous change on T2FS MRI immediately after successful antibiotic therapy are related with subsequent intervertebral autofusion, which should be carefully considered when assessing therapeutic response in PVO.

Clinical impact of radioactive iodine dose selection based on the number of metastatic lymph nodes in patients with papillary thyroid carcinoma: A multicenter retrospective cohort study.

OBJECTIVE: The aim of this study is to investigate whether the number of metastatic lymph nodes (LNs) could be used as a basis in the radioactive iodine (RAI) dose selection for patients with papillary thyroid carcinoma (PTC). PATIENTS: A total of 595 patients with PTC who received first RAI therapy after total or near-total thyroidectomy and had no evidence of disease in treatment response assessment were retrospectively enroled from five hospitals. The patients were classified into two subgroups based on the number of metastatic LNs (>5). The multivariate Cox-proportional hazard model was performed to identify the significant factors for recurrence prediction in each group as well as all enroled patients. RESULTS: Overall, 22 (3.7%) out of 595 patients had the recurrent disease during the follow-up period. The number of metastatic LNs (>5) was only a significant factor for recurrence prediction in all enroled patients (odds ratio: 7.834, p < .001). In the subgroup with ≤5 metastatic LNs, the presence of extrathyroidal extension was only associated with recurrence (odds ratio: 7.333, p = .024) in multivariate analysis. RAI dose was significantly associated with recurrence rate in which the patients with high-dose RAI (3.7 GBq or higher) had less incidence of recurrence than those with low-dose RAI (1.11 GBq) in the subgroup with more than five metastatic LNs (odds ratio: 6.533, p = .026). CONCLUSIONS: High-dose RAI (≥3.7 GBq) therapy significantly lowered the recurrence rate in patients with more than five metastatic LNs. Therefore, RAI dose should be determined based on the number of metastatic LNs as well as conventional risk factors.

The Findings of SPECT/CT Concerning Bypass Lymph Circulation in Lymphedema Following Breast Cancer Surgery.

This study aimed to determine whether bypass circulation was present in lymphedema and its effect. This was a retrospective, cross-sectional study. Patients who underwent unilateral breast cancer surgery with axillary lymph node dissection were recruited and underwent single-photon emission tomography/computed tomography (SPECT/CT). SPECT/CT was performed to detect the three-dimensional locations of radio-activated lymph nodes. Patients with radioactivity in anatomical locations other than axillary lymph nodes were classified into a positive group. All patients received complete decongestive therapy (CDT). Exclusion criteria were as follows: History of bilateral breast cancer surgery, cervical lymph node dissection history, and upper extremity amputation. The difference in the upper extremity circumference (cm) was measured at four points: Mid-point of the upper arm, elbow, and 10 and 15 cm below the elbow. Twenty-nine patients were included in this study. Fifteen patients (51.7%) had bypass lymphatic systems on the affected side, six (20.7%) had a bypass lymphatic system with axillary lymph nodes on the unaffected side, and 11 (37.9%) showed new lymphatic drainage. The positive group showed significantly less swelling than the negative group at the mid-arm, elbow, and 15 cm below the elbow. Bypass lymphatic circulation had two patterns: Infraclavicular lymph nodes and supraclavicular and/or cervical lymph nodes. Changes in lymph drainage caused by surgery triggered the activation of the superficial lymphatic drainage system to relieve lymphedema. Superficial lymphatic drainage has a connection through the deltopectoral groove.

F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the infection of heart.

Infections involving the heart are becoming increasingly common, and a timely diagnosis of utmost importance, despite its challenges. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a recently introduced diagnostic tool in cardiology. This review focuses on the current evidence for the use of FDG PET/CT in the diagnosis of infective endocarditis, cardiac implantable device infection, left ventricular assist device infection, and secondary complications. The author discusses considerations when using FDG PET/CT in routine clinical practice, patient preparation for reducing physiologic myocardial uptake, acquisition of images, and interpretation of PET/CT findings. This review also functions to highlight the need for a standardized acquisition protocol.

Assessment of Therapeutic Response in Pyogenic Vertebral Osteomyelitis Using 18F-FDG-PET/MRI.

PURPOSE: There is still no definite method to determine therapeutic response in pyogenic vertebral osteomyelitis (PVO). We analyzed the value of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) for assessing therapeutic response in PVO. METHODS: This retrospective study included 53 patients (32 men and 21 women) with lumbar PVO. The results of clinical assessments for therapeutic response were divided into "Cured" (group C) and "Non-cured" (group NC). The differences in clinical and radiological features of PVO lesions between the two groups were analyzed using clinical data and simultaneous FDG-PET/magnetic resonance imaging (MRI) obtained at each clinical assessment. RESULTS: Clinical assessments and FDG-PET/MRIs were performed at 41.89 ± 16.08 (21-91) days of parenteral antibiotic therapy. There were 39 patients in group C and 14 in group NC. Diagnostic accuracies (DAs) of FDG uptake intensity-based interpretation and C-reactive protein (CRP) for residual PVO were as follows (p < 0.01): 84.9% of the maximum standardized uptake value of PVO lesion (PvoSUVmax), 86.8% of ΔPvoSUVmax-NmlSUVmax (SUVmax of normal vertebra), 86.8% of ΔPvoSUVmax-NmlSUVmean (SUVmean of normal vertebra), and 71.7% of CRP. DAs were better (92.5-94.3%) when applying FDG uptake intensity-based interpretation and CRP together. Under the FDG uptake distribution-based interpretation, FDG uptake was significantly limited to intervertebral structures in group C (p = 0.026). CONCLUSION: The interpretations of intensity and distribution of FDG uptake on FDG-PET are useful for detecting residual PVO in the assessment of therapeutic response of PVO. The combination of FDG-PET and CRP is expected to increase DA for detecting residual PVO.

Clinical and Radiological Analysis of Pyogenic Vertebral Osteomyelitis Immediately after Successful Antimicrobial Therapy: Considerations for Assessing Therapeutic Response.

PURPOSE: The clinical and radiological abnormal findings continue even after successful treatment in pyogenic vertebral osteomyelitis (PVO). We analyzed the clinical and radiological features of cured PVO based on 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging (FDG-PET/MRI) and compared the radiological differences between FDG-PET and MRI for assessing therapeutic response in PVO. METHODS: This study included 43 patients (28 men and 15 women) with lumbar PVO who had no recurrence after successful antimicrobial therapy. They were divided into two groups based on the location of maximum standardized FDG uptake value (SUVmax) of PVO lesion on FDG-PET/MRI when parenteral antibiotics were discontinued (31 in group A: Intervertebral structure; 12 in group B: Vertebral body and paravertebral muscle). The differences of clinical symptoms, hematological inflammatory indices, and radiological features were retrospectively analyzed. RESULTS: The patients were treated with 42.28 ± 14.58 (21-89) days of parenteral antibiotics. There were significant differences in C-reactive protein (0.97 ± 1.10 vs. 0.51 ± 0.31 mg/dL, p = 0.041; normal range of CRP < 0.5), back pain (4.29 ± 1.13 vs. 3.50 ± 1.00, p = 0.040; visual analog scale), and SUVmax (4.34 ± 1.24 vs. 5.89 ± 1.57, p < 0.001) between the two groups. In the distribution pattern of PVO lesions, FDG-PET overall showed recovery pattern earlier than MRI did (p < 0.001). CONCLUSIONS: In cured PVO, the clinical features vary depending on the location of major structural damage of PVO lesion. The involvement of intervertebral structure is related with sustained back pain and elevation of CRP, and vertebral body/paravertebral muscle shows favorable clinical features despite advanced structural damages.

Application of Simultaneous 18F-FDG PET/MRI for Evaluating Residual Lesion in Pyogenic Spine Infection: a Case Report.

Magnetic resonance imaging (MRI) is the preferred imaging method for evaluating treatment response in spine infection. However, there are still no definite correlation between follow-up MRI findings and clinical status. Recently, Fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) shows great potential as diagnostic and monitoring options. Simultaneous 18F-FDG PET/MRI makes us to expect a huge synergic effect on diagnosis and evaluation of treatment response with metabolic and anatomical advantages in spine infection. We introduce an application of 18F-FDG PET/MRI for evaluating residual lesion in the patient with pyogenic spine infection.

Prognosis-Predicting Model Based on [18F]fluorodeoxyglucose PET Metabolic Parameters in Locally Advanced Cervical Cancer Patients Treated with Concurrent Chemoradiotherapy: Multi-Center Retrospective Study.

This study aimed to develop a prognosis-predicting model based on [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and clinicopathologic factors in locally advanced cervical cancer patients treated with concurrent chemoradiotherapy (CCRT). The medical records of 270 locally advanced cervical cancer patients who were treated with CCRT were collected from three institutions and reviewed retrospectively. A nomogram was used for predicting 2-year disease-free survival (DFS) and 5-year overall survival (OS) based on Cox proportional hazards regression. Predictor variables included nodal maximum standardized uptake value (SUVmax), primary tumor SUVmax, age, tumor size, stage, serum squamous cell carcinoma antigen level, and human papillomavirus status. Internal nomogram validation was performed. A nomogram for predicting the 2-year DFS and 5-year OS was constructed using six and seven parameters, respectively. With a focus on 2-year DFS, our model found nodal SUVmax to be the highest weighted negative prognostic factor. With a focus on 5-year OS, young age was the highest weighted negative prognostic factor. The concordance index was 0.75 and 0.78 for the 2-year DFS and 5-year OS, respectively. This nomogram is a predictive tool that can be used to counsel patients for predicting survival outcomes. Moreover, our prognosis-predicting model may make it possible to personalize treatment.