PT  - JOURNAL ARTICLE
AU  - Nakajima, Reiko
AU  - Patel, Snehal G.
AU  - Schoder, Heiko
TI  - Prognostic value of <sup>18</sup>F-FDG PET/CT Imaging in Recurrent Salivary Gland Cancers
DP  - 2019 May 01
TA  - Journal of Nuclear Medicine
PG  - 1263--1263
VI  - 60
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/60/supplement_1/1263.short
4100  - http://jnm.snmjournals.org/content/60/supplement_1/1263.full
SO  - J Nucl Med2019 May 01; 60
AB  - 1263Purpose: We evaluated the prognostic value of total body metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured using FDG-PET/CT in patients with recurrent salivary gland cancer (RSGC). Methods: Between January 2002 and December 2015, 80 RSGC patients were enrolled in the study. We determined the maximum standardized uptake values (SUVmax), MTV (volume encompassed by a 42% isocontour around the voxel with the highest PET uptake), and TLG (calculated by multiplying MTV by mean SUV). TMTV and TLG values are defined as the sum of MTVs and TLGs of all lesions, respectively. We correlated PET findings with progression free survival (PFS) and overall survival (OS). Results: Among the 80 patients, sixty-one patients had progressive disease or died, and 56 patients died during the study period. The median PFS and OS time were 14.1 months (range, 0.1-54.4) and 20.7 months (range, 0.1-98.2), respectively. The median SUVmax was 7.4 ± 7.1 (range, 2.2-40.9), TMTV was 29.0 ± 96.5 (range, 1.7-690.1), and median TLG was 91.3 ± 696.5 (range, 2.3-43,15.8). Univariate Cox proportional hazards regression model analysis investigated the association between clinical parameters; metabolic parameters; and PFS and OS. Univariate Cox analysis of PFS and OS demonstrated that histology, TMTV, and TLG were associated with significantly lower PFS and OS rates. Clinical parameters and SUVmax were not associated with PFS and OS (p > 0.05). Multivariate Cox proportional hazards regression model analysis identified histology (p = 0.003; hazard ratio, 2.27; 95% CI, 1.33- 3.89) and TLG (p < 0.001; hazard ratio, 1.00; 95% CI, 1.00-1.001) as independent prognostic factors for PFS after recurrence (Table 1). For OS, only TLG (p < 0.001; hazard ratio, 1.00; 95% CI, 1.00-1.001) was identified as an independent prognostic factor. The 18 months PFS rates for patients with TLG ≤91.3 g/mLcm3 and >91.3 g/mLcm3 were 53.2% and 35.1%, and for adenocarcinoma and non-adenocarcinoma were 20.5% and 60.4%, respectively. The 18 months OS rates for patients with TLG ≤91.3 g/mLcm3 and >91.3 g/mLcm3 were 62.0% and 47.4%, respectively. Conclusions: TLG on restaging FDG-PET predicted PFS and OS in patients with RSGC; patients with predicted poor outcome may benefit from alternate, escalated treatment strategies. View this table:Multivariate analysis of clinicopathological and imaging parameters