Postradiotherapy Response Assessment Using 18F-FDG PET/CT in Salivary Gland Carcinoma-A Multicenter Study.

Autor:	Chen PY; From the Radiation Oncology., Cheng NM, Lin CY; From the Radiation Oncology., Chang KP; Otorhinolaryngology-Head & Neck Surgery., Lu YA; Otorhinolaryngology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan., Tsai TY; Otorhinolaryngology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan., Chen MF, Fang FM; Radiation Oncology, Chang Gung Memorial Hospital at Kaohsiung and Chang Gung University College of Medicine, Kaohsiung., Hsu CL; Medical Oncology., Hsieh RC
Jazyk:	angličtina
Zdroj:	Clinical nuclear medicine [Clin Nucl Med] 2024 Oct 30. Date of Electronic Publication: 2024 Oct 30.
DOI:	10.1097/RLU.0000000000005538
Abstrakt:	Purpose: This multicenter study investigates the efficacy of 18F-FDG PET/CT in postradiotherapy (post-RT) response evaluation in salivary gland carcinoma (SGC). Methods: We retrospectively reviewed 115 SGC patients who underwent definitive or adjuvant RT followed by 18F-FDG PET/CT between 2004 and 2021. Most tumors were parotid gland malignancies (50%). The most common histological subtypes were adenoid cystic (29%) and mucoepidermoid carcinomas (18%). Results: The median follow-up was 65 months. Post-RT anatomic images (CT/MRI) revealed complete response (CR) in 51 patients (44%). Among 53 patients with partial response or stable disease, only 17 (32%) patients experienced locoregional recurrence, with a 5-year locoregional control rate of 69%. Post-RT 18F-FDG PET/CT documented metabolic CR in 81 patients (70%). Metabolic complete responders had significantly higher 5-year locoregional control (90% vs 43%), distant metastasis-free survival (80% vs 48%), progression-free survival (76% vs 24%), and overall survival rates (89% vs 42%) compared with non-complete responders (all P < 0.001), as confirmed in both univariate and multivariate analyses. It identified additional viable tumors in 18 cases (16%) and facilitated salvage local therapies in 7 patients (6%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of post-RT 18F-FDG PET/CT were 63%, 91%, 70%, 88%, and 84%, respectively, in predicting locoregional recurrence. 18F-FDG PET/CT showed significantly higher sensitivity (88% vs 36%, P = 0.011) in tumors with pre-RT SUVmax ≥7.39 compared with those with SUVmax <7.39. Conclusions: Post-RT 18F-FDG PET/CT demonstrates high negative predictive value and specificity, with metabolic CR predicting excellent outcomes. Additionally, it exhibits higher sensitivity for high-SUVmax SGC, facilitating early detection of viable tumors. Competing Interests: Conflicts of interest and sources of funding: none declared. This study was made possible through the financial support of grants NMRPG3M6301 (NSTC111-2314-B-182A-160-MY2) and NMRPG3N6111 (NSTC112-2628-B-182A-007-MY3) from the National Science and Technology Council, the Yushan Fellow Program (MOE-113-YSFMN-1009-001-P1) from the Ministry of Education, as well as grants CMRPG3N0522 and CPRPG3P0031 from the Chang Gung Medical Foundation in Taiwan. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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