Role of 18F-FDG PET/CT Volumetric Metabolic Parameters in the Staging of Head and Neck Squamous Cell Carcinoma

Saturday, September 28, 2024

10:18 AM – 10:24 AM EDT

Location: MBCC, 206

Disclosure(s):

Andrea Migliorelli, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Marianna Manuelli, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The 18F-FDG PET/CT (FDG PET) represents a staging method of head and neck squamous cell cancers (HNSCC). Maximum standardized uptake value (SUVmax) is usually used as a benchmark, in contrast, there are few studies examining the efficacy of volumetric metabolic parameters such as Metabolic Tumor Volume (MTV) and Total Lesion Glycolysis (LTG). The aim of this study is to evaluate the positive predictive value of SUVmax, MTV and LTG in staging HNSCC, and to estimate a threshold value for the detection of cervical lymph node metastasis by ROC curve.
Finally, we evaluated if inflammatory parameters (NRL, PRL, MRL) could affect FDG PET results.

Methods: A retrospective study was conducted by analyzing the data of patients who underwent FDG PET for staging HNSCC between 2015-2022 at the Nuclear Medicine Unit of the University Hospital of Ferrara. All patients had at least one cytologic or histologic confirmation of the primary tumor and suspicious cervical lymph nodes.

Results: We enrolled 89 patients (69 males, 20 females). Preoperative MTV and LTG values on T were significantly higher in patients who developed distant recurrence post-treatment (p < 0.001; p = 0.041, respectively). ROC curve analysis on lymph node uptake showed that LTG had a sensitivity of 76% and specificity of 97% in identifying lymph node metastasis at staging, with a cut-off value of 10.150. Preoperative inflammatory parameters do not influence FDG PET results.

Conclusions: FDG PET is an effective tool in staging HNSCCs. Volumetric metabolic parameters (MTV and LTG) have proven useful as complementary methods to SUVmax in HNSCC staging.

Co-Author(s)

Andrea Migliorelli, MD

PhD Candidate
ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
Ferrara, Emilia-Romagna, Italy

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Presenting Author(s)

Marianna Manuelli, MD

Resident
ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
Ferrara, Emilia-Romagna, Italy

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

IC

Isotta Campomagnani, MD

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.
DE

Diana Ehsani, MD

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.
AB

Alessandro Borrelli, MD

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.
MC

Matteo Caracciolo, MD

Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.
NO

Naima Ortolan, MD

Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.
FB

Francesca Borgia, MD

Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.
VC

Virginia Corazzi, MD

ENT and Audiology Unit, Department of Neurosciences, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.
AC

Andrea Ciorba, MD

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.
MB

Mirco Bartolomei, MD

Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.

Senior Author(s)

CB

Chiara Bianchini, MD

Associate Professor
ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
Ferrara, Emilia-Romagna, Italy

Disclosure information not submitted.
SP

Stefano Pelucchi, MD

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy, United States

Disclosure information not submitted.