Valor pronóstico de los parámetros metabólicos volumétricos del tumor primario y ganglios linfáticos en el PET/TC pretratamiento en el carcinoma nasofaríngeo / Prognostic value of primary tumor and lymph node volumetric metabolic parameters at pre-treatment F-18 FDG PET/CT in nasopharyngeal carcinoma

Objetivo El objetivo de este estudio fue evaluar el significado pronóstico de los parámetros metabólicos volumétricos de la PET/TC pretratamiento junto con las características clínicas en pacientes con carcinoma nasofaríngeo no metastásico. Material y métodos Setenta y nueve pacientes con carcinoma nasofaríngeo se sometieron a una PET/TC con [18F]FDG para evaluación previa al tratamiento y se incluyeron en este estudio. Se analizaron las características del paciente (edad, histopatología del tumor, estadio T/N, tamaño del tumor primario y ganglio cervical más grande) y parámetros PET: valores de captación estandarizados máximo, medio y pico (SUVmáx, SUVmean, SUVpico), volumen tumoral metabólico (MTV) y glucólisis de lesión total (TLG) para el tumor primario y el ganglio linfático cervical más grande. El análisis de supervivencia para la supervivencia libre de progresión (PFS) y la supervivencia global (OS) se realizó con el método de Kaplan-Meier utilizando los hallazgos de PET y las características clínicas. Resultados La mediana de duración del seguimiento fue de 29,7 meses (rango 3-125 meses). El MTV del tumor primario y el MTV de los ganglios linfáticos cervicales fueron factores pronósticos independientes para la PFS (p = 0,025 y p = 0,004, respectivamente). Los pacientes con MTV del tumor primario > 19,4 y los pacientes con MTV de los ganglios linfáticos > 3,4 tuvieron una PFS más corta. Para OS, la edad y el tamaño del ganglio linfático fueron factores pronósticos independientes (p = 0,031 y p = 0,029). Los pacientes mayores de 54 años y los pacientes con ganglios linfáticos > 1 cm se asociaron con una OS disminuida. Conclusión El MTV del tumor primario y el MTV de los ganglios linfáticos en la PET/TC previa al tratamiento son factores pronósticos significativos para la PFS a largo plazo en el carcinoma nasofaríngeo no metastásico (AU)

Background The aim of this study was to evaluate the prognostic significance of volumetric metabolic parameters of pre-treatment PET/CT along with clinical characteristics in patients with non-metastatic nasopharyngeal carcinoma. Material and methods Seventy-nine patients with nasopharyngeal carcinoma underwent F18-FDG PET/CT for pretreatment evaluation and included in this study. The patient features (patient age, tumor histopathology, T and N stage, size of primary tumor and the largest cervical lymph node) and PET parameters were analyzed: maximum, mean and peak standardized uptake values (SUVmax, SUVmean, SUVpeak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumor and largest cervical lymph node. After treatment, patients were evaluated for disease progression and mortality. Survival analysis for progression-free survival (PFS) and over-all survival (OS) was performed with Kaplan–Meier method using PET findings and clinical characteristics. Results The median follow-up duration was 29.7 months (range 3–125 months). Among clinical characteristics, no parameters had significance association for PFS. Primary tumor-MTV and cervical lymphnode-MTV were independent prognostic factors for PFS (p = 0.025 and p = 0.004, respectively). Patients with primary tumor-MTV > 19.4 and patients with lymph node-MTV > 3.4 had shorter PFS. For OS, age and the size of the lymph node were independent prognostic factor (p = 0.031 and p = 0.029). Patients with age over 54 years and patients with lymph node size > 1 cm were associated with decreased OS. Conclusion Primary tumor-MTV and lymph node-MTV on pre-treatment PET/CT are significant prognostic factors for long-term PFS in non-metastatic nasopharyngeal carcinoma (AU)

Standardized uptake value and metabolic tumor volume measured by ¹8F FDG PET/CT are sensitive biomarkers for the presence of lymph node metastasis in patients with cervical carcinoma.

UNLABELLED: The aim of this study was to evaluate whether tumor standardized uptake value (SUVmax) and metabolic tumor volume (MTV) associate with the presence of PET-positive pelvic/para-aortic lymph nodes (LN) in cervical cancer patients. METHOD: Seventy-four patients with stage IB-IVB cervical cancer (squamous [n:66], nonsquamous [n:8]), who were referred to FDG-PET/CT department for initial staging, were enrolled in this study. RESULTS: Patients were staged according to International Federation of Gynecology and Obstetrics [FIGO] criteria as; stage I (n:5), stage II (n:25), stage III (n:15) and stage IV (n:29). PET/CT detected 53 patients with hypermetabolic LN (average SUVmax: 7.5 ± 4.1, range: 4.1-22.8, pelvic LN: 29 patients, para-aortic LN:5 patients, pelvic and para-aortic LN:19 patients). SUVmax and MTV were significantly higher in patients with PET-positive LN compared to others (18.4 and 88.8 cm(3) vs. 13.9 and 39.9 cm(3) respectively, p = 0.007 for SUVmax, p = 0.0001 for MTV). Cut-off values in association with PET-positive LN were 15.2 for SUVmax and 35 cm(3) for MTV on ROC curve analysis. There was no correlation between SUVmax and MTV (correlation coefficient (R(2)) = 0.07). MTV differed significantly with FIGO stages (41, 98 and 107 cm(3), in stage II, III and IV respectively, p = 0.015). CONCLUSION: Presence of PET-positive LN correlates with tumor SUVmax and MTV of cervical tumor. These findings support the use of PET/CT in the pretreatment evaluation of cervical cancer patients in order to identify cases with high risk of lymphatic involvement.

Respiratory epithelial adenomatoid hamartoma (REAH) of the nasopharynx with high 18F-FDG uptake on PET/CT.

Respiratory epithelial adenomatoid hamartoma (REAH) is a rare benign non-neoplastic sinonasal lesion that usually presents in the nasal cavity, paranasal sinuses, or olfactory cleft. We report a case of nasopharynx REAH mimicking a malignant tumour with incidental high 18-FDG uptake in a patient with colon cancer. Less than five similar cases have been reported to date, and this is the first case of REAH to show high uptake on PET/CT scans. Although hamartoma arising from the nasopharynx region is very rare, it should be considered in the differential diagnosis because it is a benign lesion and complete surgical resection is curative.