BACKGROUND The Hopkins criteria were introduced for nodal response evaluation after therapy in head and neck cancer, but its superiority over quantification is not yet confirmed. METHODS SUVbody weight thresholds and lesion-to-background ratios were explored in a prospective multicenter study of standardized FDG-PET/CT 12 weeks after CRT in newly diagnosed locally advanced head and neck squamous cell carcinoma (LAHNSCC) patients (ECLYPS). Reference standard was histology, negative FDG-PET/CT at 12 months after treatment or ≥ 2 years of negative follow-up. Area under the receiver operator characteristics curves (AUROC) were estimated and obtained thresholds were validated in an independent cohort of HNSCC patients (n = 127). RESULTS In ECLYPS, 124 patients were available for quantification. With a median follow-up of 20.4 months, 23 (18.5%) nodal neck recurrences were observed. A SUV70 threshold of 2.2 (AUROC = 0.89; sensitivity = 79.7%; specificity = 80.8%) was identified as optimal metric to identify nodal recurrence within 1 year after therapy. For lesion-to-background ratios, an SUV50/SUVliver threshold of 0.96 (AUROC = 0.89; sensitivity = 79.7%; specificity = 82.8%) had the best performance. Compared with Hopkins criteria (AUROC = 0.81), SUV70 and SUV50/SUVliver provided a borderline significant (p = 0.040 and p = 0.094, respectively) improvement. Validation of thresholds yielded similar AUROC values (SUV70 = 0.93, SUV50/SUVliver = 0.95), and were comparable to the Hopkins score (AUROC = 0.91; not statistically significant). CONCLUSION FDG quantification detects nodal relapse in LAHNSCC patients. When using EARL standardized PET acquisitions and reconstruction, absolute SUV metrics (SUV70 threshold 2.2) prove robust, yet ratios (SUV50/SUVliver, threshold 0.96) may be more useful in routine clinical care. In this setting, the diagnostic value of quantification is comparable to the Hopkins criteria. TRIAL REGISTRATION US National Library for Medicine, NCT01179360. Registered 11 August 2010, https://clinicaltrials.gov/ct2/show/NCT01179360.

中文翻译：

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量化 18F-氟脱氧葡萄糖摄取以检测局部晚期头颈部鳞状细胞癌放化疗后残留淋巴结疾病：ECLYPS 研究的结果。

背景 霍普金斯标准被引入用于头颈癌治疗后的淋巴结反应评估，但其优于量化的优越性尚未得到证实。方法 在新诊断的局部晚期头颈部鳞状细胞癌 (LAHNSCC) 患者 (ECLYPS) 的 CRT 后 12 周标准化 FDG-PET/CT 的前瞻性多中心研究中探索 SUV 体重阈值和病变背景比。参考标准是组织学检查、治疗后 12 个月 FDG-PET/CT 阴性或 ≥ 2 年的阴性随访。在独立的 HNSCC 患者队列 (n = 127) 中估计接收者操作特征曲线 (AUROC) 下的面积并验证获得的阈值。结果 在 ECLYPS 中，124 名患者可用于量化。中位随访时间为 20.4 个月，23 (18. 5%) 观察到淋巴结颈部复发。SUV70 阈值为 2.2（AUROC = 0.89；敏感性 = 79.7%；特异性 = 80.8%）被确定为在治疗后 1 年内识别淋巴结复发的最佳指标。对于病变与背景的比率，SUV50/SUVliver 阈值为 0.96（AUROC = 0.89；敏感性 = 79.7%；特异性 = 82.8%）具有最佳性能。与霍普金斯标准（AUROC = 0.81）相比，SUV70 和 SUV50/SUVliver 提供了显着的临界改善（分别为 p = 0.040 和 p = 0.094）。阈值的验证产生了相似的 AUROC 值（SUV70 = 0.93，SUV50/SUVliver = 0.95），并且与霍普金斯评分相当（AUROC = 0.91；无统计学意义）。结论 FDG 定量检测 LAHNSCC 患者的淋巴结复发。使用 EARL 标准化 PET 采集和重建时，绝对 SUV 指标（SUV70 阈值 2.2）证明是稳健的，但比率（SUV50/SUVliver，阈值 0.96）可能在常规临床护理中更有用。在这种情况下，量化的诊断价值与霍普金斯标准相当。试用注册美国国家医学图书馆，NCT01179360。2010 年 8 月 11 日注册，https://clinicaltrials.gov/ct2/show/NCT01179360。