FDG tumor volumetric parameters and outcome in lung cancer and head and neck cancer
Lung cancer (LC) is the leading cause of cancer mortality worldwide and second most common type of cancer in the United States in both genders. Moreover, Head and neck cancer (HNC) is the sixth most common cancer worldwide and 4% of all malignancies in the United States. The role of FDG-PET-CT has recently increased in oncology for diagnosis, treatment monitoring and patient prognosis. FDG Metabolic parameters sued to assess patient care include maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), and total glycolytic activity. This study attempts to prove FDG-metabolic parameters reliability in LC and HNC patients before and after treatment among readers with different levels of experience. Three readers, 2 experienced and 1 inexperienced, read before and after treatment scans of 74 FDG-PET-CT scans from 13 lung cancer patients and 24 head and neck cancer patients. Lesion location was provided beforehand and reliability was tested using intra-class correlation coefficients (ICC) and ANOVA analysis. For every case, ICC was >0.81 (almost perfect agreement) among all readers and ANOVA showed no statistical significance (p>0.05) on the any of the measurements among all readers as well. We concluded that FDG-PET-CT metabolic parameters (SUVmax, MTV, and TGA) are reliable measurements for treatment response in LC and HNC patients and are independent of reader experience as long as lesion location is provided. These parameters have been found to accurately correlate with tumor behavior and patient prognosis; therefore, reliability on its accurate measurement provides strength to FDG-PET-CT as an imaging modality of choice for oncology patients.
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