The feasibility of 18F-FDG-PET in a prognostic factor of paranasal sinus malignancy

Abstract

This study was designed to assess whether tumor uptake of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) expressed as the maximum standardized uptake value (SUVmax) can be used to predict survival in subjects with paranasal sinus malignancy. Furthermore, a prognostic SUVmax was determined by univariate and bivariate analyses.We enrolled 42 consecutive subjects with a histological diagnosis of squamous cell carcinoma in paranasal sinus malignancy from January 2005 through October 2011, into a retrospective institutional imaging trial. Thirty-eight subjects (90.5%) underwent a baseline FDG-PET scan before curative treatment and were eligible for analysis.A total of thirty-eight subjects with paranasal sinus malignancy undergoing PET/CT imaging in the initial stages were assessed separately for a potential correlation between SUVmax and T-staging, histological grading, and overall survival. Log-rank testing revealed a significant correlation between overall survival and histologic grading (p=0.046); and there was some correlation between SUVmax and histologic grading, it was that the histologic grading was poorer, the SUVmax was higher (p=0.446). ROC curve was identified for cutoff value of SUVmax as prognostic factor by Youden index. And We compared the low tumor of SUVmax group with high tumor of SUVmax group divided by cutoff value of SUVmax. It was assumed that in the high SUVmax group, a high T stage value had a greater association with poorer outcomes than a low T stage value (p=0.035). We did find a significant correlation between SUVmax and disease control, and mortality (p=0.003, p<0.001).In our study, it is concluded that subjects with higher tumor FDG uptakes should be considered for a more aggressive treatment approach