Post-treatment FDG PET-CT in head and neck carcinoma: comparative analysis of 4 qualitative interpretative criteria in a large patient cohort.
Adult
Aged
Aged, 80 and over
Chemoradiotherapy
/ mortality
Female
Fluorodeoxyglucose F18
/ metabolism
Follow-Up Studies
Head and Neck Neoplasms
/ diagnostic imaging
Humans
Male
Middle Aged
Positron Emission Tomography Computed Tomography
/ methods
Prognosis
Prospective Studies
Radiopharmaceuticals
/ metabolism
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck
/ diagnostic imaging
Survival Rate
Young Adult
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
05 03 2020
05 03 2020
Historique:
received:
04
09
2019
accepted:
12
02
2020
entrez:
7
3
2020
pubmed:
7
3
2020
medline:
24
11
2020
Statut:
epublish
Résumé
There is no consensus regarding optimal interpretative criteria (IC) for Fluorine-18 fluorodeoxyglucose (FDG) Positron Emission Tomography - Computed Tomography (PET-CT) response assessment following (chemo)radiotherapy (CRT) for head and neck squamous cell carcinoma (HNSCC). The aim was to compare accuracy of IC (NI-RADS, Porceddu, Hopkins, Deauville) for predicting loco-regional control and progression free survival (PFS). All patients with histologically confirmed HNSCC treated at a specialist cancer centre with curative-intent non-surgical treatment who underwent baseline and response assessment FDG PET-CT between August 2008 and May 2017 were included. Metabolic response was assessed using 4 different IC harmonised into 4-point scales (complete response, indeterminate, partial response, progressive disease). IC performance metrics (sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy) were compared. Kaplan-Meier and Cox proportional hazards regression analyses were performed for survival analysis. 562 patients were included (397 oropharynx, 53 hypopharynx, 48 larynx, 64 other/unknown primary). 420 patients (75%) received CRT and 142 (25%) had radiotherapy alone. Median follow-up was 26 months (range 3-148). 156 patients (28%) progressed during follow-up. All IC were accurate for prediction of primary tumour (mean NPV 85.0% (84.6-85.3), PPV 85.0% (82.5-92.3), accuracy 84.9% (84.2-86.0)) and nodal outcome (mean NPV 85.6% (84.1-86.6), PPV 94.7% (93.8-95.1), accuracy 86.8% (85.6-88.0)). Number of indeterminate scores for NI-RADS, Porceddu, Deauville and Hopkins were 91, 25, 20, 13 and 55, 70, 18 and 3 for primary tumour and nodes respectively. PPV was significantly reduced for indeterminate uptake across all IC (mean PPV primary tumour 36%, nodes 48%). Survival analyses showed significant differences in PFS between response categories classified by each of the four IC (p <0.001). All four IC have similar diagnostic performance characteristics although Porceddu and Deauville scores offered the best trade off of minimising indeterminate outcomes whilst maintaining a high NPV.
Identifiants
pubmed: 32139722
doi: 10.1038/s41598-020-60739-3
pii: 10.1038/s41598-020-60739-3
pmc: PMC7058010
doi:
Substances chimiques
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4086Références
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