AUTHOR=Morand Grégoire B. , Broglie Martina A. , Schumann Paul , Huellner Martin W. , Rupp Niels J. 

TITLE=Histometabolic Tumor Imaging of Hypoxia in Oral Cancer: Clinicopathological Correlation for Prediction of an Aggressive Phenotype

JOURNAL=Frontiers in Oncology

VOLUME=Volume 10 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.01670

DOI=10.3389/fonc.2020.01670

ISSN=2234-943X

ABSTRACT=Introduction: Fluorodeoxyglucose-positron emission tomography (FDG-PET) is a widely used imaging tool for oral squamous cell carcinoma (OSCC). Preliminary studies indicate that quantification of tumor metabolic uptake may correlate with tumor hypoxia and aggressive phenotypes.

Methods: Retrospective review of a consecutive cohort of OSCC with available pretherapeutic FDG-PET/CT, treated at the University Hospital Zurich. Clinico-pathologico-radiological correlation between maximum standard uptake value (SUVmax) of the primary tumor, immunohistochemical staining for hypoxia-related proteins GLUT1 and HIF1a, depth of invasion (DOI), lymph node metastasis, and outcome was examined.

Results: Positive staining for GLUT1 and HIF1a on immunhistopathological analysis correlated with increased SUVmax on pretherapeutic imaging and with increased DOI (Kruskal-Wallis, P=0.037 and P=0.008, resp.). SUVmax and DOI showed a strong positive correlation (Spearman Rho, correlation coefficient= 0.451, P= 0.0003). An increase in SUVmax predicted nodal metastasis (Kruskal-Wallis, P=0.017) and poor local control (Log rank, P=0.047)

Conclusion: In OSCC, FDG-PET-derived metabolic tumor parameter SUVmax serves as a surrogate marker for hypoxia and can be used to predict tumor aggressiveness, with more invasive phenotype and poorer local control.