Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Oral Radiol. 2019 Sep;35(3):308-314. doi: 10.1007/s11282-019-00377-2. Epub 2019 Feb 18.
L-3-[F]-Fluoro-α-methyl tyrosine (FAMT), an amino acid positron emission tomography (PET) tracer, complements [F]-fluorodeoxyglucose (FDG) in the diagnosis of malignancies. We compared the predictive ability of FAMT PET versus FDG PET regarding metastatic oral squamous cell carcinoma (OSCC) outcomes for distant metastasis, including lymph node metastasis, and identified the relevant metabolic parameters for each.
We enrolled 160 patients with OSCC who underwent PET/computed tomography using FDG and FAMT before treatment. Outcomes were assessed using clinicopathological characteristics such as the standardized uptake value (SUV, SUV), metabolic tumor volume (MTV), and total lesion glycolysis or total lesion retention. Univariate and multivariate Cox proportional hazards models were used to identify the independent predictors of disease-free survival (DFS) and overall survival (OS) during an average follow-up time of 1401.7 and 1646.0 days, respectively. Areas under the receiver operating characteristic curves were analyzed for the accuracy and predictive value of imaging parameters.
Clinical parameters (excluding age) and PET metabolic parameters were significantly associated with OS. Multivariate analysis showed that an infiltrative growth pattern [p = 0.034, hazard ratio (HR) = 2.30], and the FDG-measured SUV (p = 0.045, HR = 2.45) were independent risk factors for DFS and that lymph node metastasis (p = 0.03, HR = 2.57) and the FAMT-measured MTV (p = 0.004, HR = 3.65) were independent risk factors for OS.
In patients with OSCC, FDG PET predicted DFS, whereas FAMT predicted OS. The two PET tracers, combined with clinical parameters, provide complementary, outcome-related diagnostic information in OSCC.
L-3-[F]-氟-α-甲基酪氨酸（FAMT）是一种氨基酸正电子发射断层扫描（PET）示踪剂，可补充[F]-氟脱氧葡萄糖（FDG）在恶性肿瘤的诊断中的作用。我们比较了 FAMT PET 与 FDG PET 在预测口腔鳞状细胞癌（OSCC）远处转移（包括淋巴结转移）中的预测能力，并确定了每种方法的相关代谢参数。
我们招募了 160 名接受 FDG 和 FAMT 治疗前 PET/计算机断层扫描的 OSCC 患者。通过临床病理特征（如标准化摄取值（SUV，SUV）、代谢肿瘤体积（MTV）和总病灶糖酵解或总病灶滞留）评估结果。使用单变量和多变量 Cox 比例风险模型来识别无疾病生存（DFS）和总生存（OS）的独立预测因素，平均随访时间分别为 1401.7 和 1646.0 天。分析受试者工作特征曲线下的面积以评估成像参数的准确性和预测价值。
临床参数（年龄除外）和 PET 代谢参数与 OS 显著相关。多变量分析显示，浸润性生长模式（p=0.034，风险比[HR]=2.30）和 FDG 测量的 SUV（p=0.045，HR=2.45）是 DFS 的独立危险因素，而淋巴结转移（p=0.03，HR=2.57）和 FAMT 测量的 MTV（p=0.004，HR=3.65）是 OS 的独立危险因素。
在 OSCC 患者中，FDG PET 预测 DFS，而 FAMT 预测 OS。这两种 PET 示踪剂与临床参数相结合，为 OSCC 提供了互补的、与结局相关的诊断信息。
