Utilization of 18F-FDG Standardized Uptake Value and Metabolic Tumor Volume to Predict Local Failure in Nasopharyngeal Carcinoma

Introduction:The aim was to evaluate the prognostic valuesof pretreatment F-18-fluorodeoxyglucose (F-18-FDG) positronemission tomography (PET) parameters for predicting localfailure in nasopharyngeal carcinoma (NPC) patients in theintensity-modulated radiotherapy (IMRT) era.Methods:Retrospective analysis was performed on 759 patientswith NPC who underwent pretreatment F-18-FDG PET. Theoptimal cutoff values for maximum standardized uptakevalue (SUVmax) and metabolic tumor volume (MTV) weredetermined by receiver operating characteristic curveanalysis. Univariate and multivariate analysis was performedto identify the prognostic factors influencing local failure-free survival (LFFS). Survival curves for the different riskgroups were plotted using the Kaplan-Meier survival analysismethod and compared using the log-rank test.Results:Themedian follow-up period was 49.0 months (range: 3.0-118.0months). The optimal cutoff of SUVmax and MTV were 7.44and 22.21 mL, respectively. Patients with higher SUVmaxand MTV were associated with worse LFFS. The survivalcurves of different groups were significantly separated. Theunivariate analysis showed the statistical significance ofSUVmax, MTV, and their composite in LFFS (p= 0.002 forSUVmax;p= 0.001 for MTV;p<0.002 for their composite).The multivariate analysis showed that higher SUVmax andMTV was an independent negative prognostic factor forLFFS (HR = 1.805, 95% CI: 1.004-3.245,p= 0.049). Thesubgroups of stages III-IV further confirmed the impact ofSUVmax and MTV on LFFS (HR = 1.884, CI: 1.087-3.708,p=0.026).Conclusion:Patients with higher SUVmax and MTVwere associated with local failure as well as in the III-IVadvanced stage.(c) 2025 S. Karger AG, Basel