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Introduction <p>This study aimed to correlate preoperative 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) tumor staging, and maximum standardized uptake values (SUV<sub>max</sub>) with preoperative CT data, postoperative tumor classification, and histopathological parameters of oral squamous cell carcinoma (OSCC).</p> Material and methods <p>Thirty-seven OSCC patients staged via full-body 18F-FDG-PET/CT, including contrast agent CT of the head and neck in 2020 and 2021, were enclosed. Patients received tumor resection and stage-dependent neck dissection. Preoperative clinical (c) 18F-FDG-PET/CT UICC tumor stages and TNM classifications were correlated to corresponding CT and to postoperative histopathological (p) UICC tumor stages and TNM classifications. SUV<sub>max</sub> of the primary tumor was associated with pUICC and pTNM, including extranodal extension (ENE), perineural invasion (Pn), lymphatic spread (L), vascular invasion (V), tumor grading (G), and -thickness.</p> Results <p>Comparing 18F-FDG-PET/CT and CT, cUICC, cT, and cN differed in 32.3%, 16.7%, and 37.8% of the cases, respectively. For 18F-FDG-PET/CT, a moderate correlation was found between c- and pUICC (0.494; <i>p</i> = 0.0018) with a misestimation of c- compared to pUICC in 43.2% of the cases. Comparing c- and pTNM, misestimations concerning c- and pT were seen in 51.4% and concerning c- and pN in 37.8% of the cases. An increased SUV<sub>max</sub> significantly correlated with increased pT- and pUICC (adjusted Odds ratio 1.103; <i>p</i> = 0.042 and 1.126; <i>p</i> = 0.021, respectively). The predictive quality of an SUV<sub>max</sub> cutoff value for detecting cervical lymph node metastases and G was poor, as indicated by the low AUC values from the ROC analysis. No correlations were found between SUV<sub>max</sub> and ENE, Pn-, L-, and V-status. A strong correlation was found between SUV<sub>max</sub> and tumor thickness with an adjusted coefficient of 1.034 (<i>p</i> = 0.01).</p> Conclusion <p>The predictive value of 18F-FDG-PET/CT and SUV<sub>max</sub> on histopathological tumor classification and parameters appears limited.</p> Clinical relevance <p>18F-FDG-PET/CT can not unreservedly be recommended for primary OSCC staging. There is an urgent need to specify its indications in detail further.</p>

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Correlation of preoperative 18F-FDG-PET/CT tumor staging and maximum standardized uptake values with preoperative CT, postoperative tumor classification, and histopathological parameters of oral squamous cell carcinoma

  • 期刊论文

  • 发表日期：

    2025年3月18日

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  • Gunnar Müller,
  • Daniel A. Veit,
  • Philipp Becker,
  • Daniel G. E. Thiem,
  • Peer W. Kämmerer,
  • Birte Diekmeyer,
  • Richard Werkmeister,
  • Diana Heimes,
  • Andreas Pabst

摘要

Introduction

This study aimed to correlate preoperative 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) tumor staging, and maximum standardized uptake values (SUVmax) with preoperative CT data, postoperative tumor classification, and histopathological parameters of oral squamous cell carcinoma (OSCC).

Material and methods

Thirty-seven OSCC patients staged via full-body 18F-FDG-PET/CT, including contrast agent CT of the head and neck in 2020 and 2021, were enclosed. Patients received tumor resection and stage-dependent neck dissection. Preoperative clinical (c) 18F-FDG-PET/CT UICC tumor stages and TNM classifications were correlated to corresponding CT and to postoperative histopathological (p) UICC tumor stages and TNM classifications. SUVmax of the primary tumor was associated with pUICC and pTNM, including extranodal extension (ENE), perineural invasion (Pn), lymphatic spread (L), vascular invasion (V), tumor grading (G), and -thickness.

Results

Comparing 18F-FDG-PET/CT and CT, cUICC, cT, and cN differed in 32.3%, 16.7%, and 37.8% of the cases, respectively. For 18F-FDG-PET/CT, a moderate correlation was found between c- and pUICC (0.494; p = 0.0018) with a misestimation of c- compared to pUICC in 43.2% of the cases. Comparing c- and pTNM, misestimations concerning c- and pT were seen in 51.4% and concerning c- and pN in 37.8% of the cases. An increased SUVmax significantly correlated with increased pT- and pUICC (adjusted Odds ratio 1.103; p = 0.042 and 1.126; p = 0.021, respectively). The predictive quality of an SUVmax cutoff value for detecting cervical lymph node metastases and G was poor, as indicated by the low AUC values from the ROC analysis. No correlations were found between SUVmax and ENE, Pn-, L-, and V-status. A strong correlation was found between SUVmax and tumor thickness with an adjusted coefficient of 1.034 (p = 0.01).

Conclusion

The predictive value of 18F-FDG-PET/CT and SUVmax on histopathological tumor classification and parameters appears limited.

Clinical relevance

18F-FDG-PET/CT can not unreservedly be recommended for primary OSCC staging. There is an urgent need to specify its indications in detail further.