Role of FDG-PET as a biological marker for predicting the hypoxic status of tongue cancer

Background To determine whether 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) could serve as a useful technique predicting tumor hypoxia and prognosis in tongue cancer, we assessed the relationship between FDG uptake and the levels of hypoxia-related markers. Methods Tumor uptake of FDG in 33 patients with T2 tongue cancer was assessed by measuring maximum standardized uptake values (SUVmax). Expression of hypoxia-inducible factor (HIF)-1 alpha, carbonic anhydrase (CA)-9, glucose transporter (GLUT)-1, and erythropoietin receptor (EPOR), was determined by immunohistochemical staining. Correlation between SUVmax and the expression of hypoxia-related markers was assessed and multivariate analysis was performed to determine what parameters affected clinical outcomes. Results We observed strong correlations between SUVmax and expression of HIF-1 alpha (p < .05), CA-9 (p < .01), and GLUT-1 (p < .01). SUVmax, HIF-1 alpha expression, and tumor grade were significant independent predictors of disease-free survival (DFS). Conclusion SUVmax may be a good noninvasive biomarker for prediction of hypoxic status and prognosis of patients with T2 tongue cancer. (c) 2011 Wiley Periodicals, Inc. Head Neck, 2011