Department of Otorhinolaryngology-Head and Neck Surgery, Puerta de Hierro University Hospital, Majadahonda, Spain.
Departamento de Cirugía, Universidad Autónoma de Madrid, Madrid, Spain.
Eur Arch Otorhinolaryngol. 2022 Sep;279(9):4577-4586. doi: 10.1007/s00405-022-07401-y. Epub 2022 May 2.
Although metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have shown good prognostic value in head and neck cancer (HNC), there are still many issues to resolve before their potential application in standard clinical practice. The purpose of this study was to compare the discrimination ability of two relevant segmentation methods in HNC and to evaluate the potential benefit of adding lymph nodes' metabolism (LNM) to the measurements.
We retrospectively analyzed a recently published database of 62 patients with HNC treated with chemoradiotherapy. MTV and TLG were measured using an absolute threshold of SUV2.5. Comparison analysis with previously published background-level threshold (BLT) results was done through Concordance index (C-index) in eight prognostic models.
BLT obtained better C-index values in five out of the eight models. The addition of LNM improved C-index values in six of the prognostic models.
We found a potential benefit in adding LNM to the main tumor measurements, as well as in using a BLT for MTV segmentation compared to the most commonly used SUV2.5 threshold. Despite its limitations, this study suggests a practical and simple manner to use these parameters in standard clinical practice, aiming to help elaborate a general consensus.
尽管代谢肿瘤体积（MTV）和总肿瘤糖酵解（TLG）在头颈部癌症（HNC）中显示出良好的预后价值，但在将其潜在应用于标准临床实践之前，仍有许多问题需要解决。本研究的目的是比较两种相关分割方法在 HNC 中的区分能力，并评估将淋巴结代谢（LNM）加入测量值的潜在益处。
我们回顾性分析了 62 例接受放化疗治疗的 HNC 患者的最近发表的数据库。使用 SUV2.5 的绝对阈值测量 MTV 和 TLG。通过在八个预后模型中的一致性指数（C 指数）比较与先前发表的背景水平阈值（BLT）结果的分析。
BLT 在八个模型中的五个中获得了更好的 C 指数值。在六个预后模型中，加入 LNM 提高了 C 指数值。
我们发现，与最常用的 SUV2.5 阈值相比，将 LNM 添加到主要肿瘤测量值中以及使用 BLT 进行 MTV 分割具有潜在益处。尽管存在局限性，但本研究提出了一种在标准临床实践中使用这些参数的实用且简单的方法，旨在帮助制定普遍共识。
