Anal cancer maximum F-18 fluorodeoxyglucose uptake on positron emission tomography is correlated with prognosis

Kidd, Elizabeth A.; Dehdashti, Farrokh; Siegel, Barry A.; Grigsby, Perry W.

doi:10.1016/j.radonc.2010.02.019

« Previous Next »Radiotherapy & Oncology
Volume 95, Issue 3 , Pages 288-291, June 2010

Anal cancer maximum F-18 fluorodeoxyglucose uptake on positron emission tomography is correlated with prognosis

Elizabeth A. Kidd
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
Farrokh Dehdashti
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
Barry A. Siegel
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
Perry W. Grigsby
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
- Corresponding author. Address: Department of Radiation Oncology, Box 8224, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 4921 Parkview Pl., St. Louis, MO 63110, USA.

Received 28 October 2008; received in revised form 17 February 2010; accepted 18 February 2010. published online 15 March 2010.

Abstract

Purpose

To evaluate anal cancer uptake of F-18 fluorodeoxyglucose (FDG) measured as the maximum standardized uptake value (SUV_max) by positron emission tomography (PET) and its correlation with prognostic factors.

Patients and methods

The study population consisted of 77 patients with stages 0–IIIB anal cancer who underwent pre-treatment FDG-PET. Tumor histology included 65 squamous cell, 11 basaloid, and 1 small cell cancers. SUV_max and sites of lymph node metastasis were recorded. We analyzed the association between SUV_max and prognostic factors.

Results

The mean SUV_max was 10.0 (range 1.0–43.1). The stage distribution included: 2 stage 0, 7 stage I, 49 stage II, 10 stage IIIA, 9 stage IIIB. SUV_max and clinical tumor size were not associated (R²=0.338). Histology did not significantly influence SUV_max (mean SUV_max 10.0 for squamous versus 9.90 for basaloid). Higher SUV_max was associated with an increased risk of nodal metastasis at diagnosis (p<0.0001). Higher SUV_max was associated with worse disease-free survival (p=0.05). Patients with high anal tumor SUV_max at diagnosis were at an increased risk of persistent or recurrent disease on post-therapy FDG-PET performed less than 4months after completing therapy (p=0.0402).