biostudies-literatureUnknown22(1)Qiu X<h4>Background</h4>To rethink the clinical significance of standardized uptake values (SUVs) of nasopharyngeal carcinoma (NPC) on ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron-emission tomography (PET).<h4>Methods</h4>We retrospectively reviewed 369 NPC patients who underwent pretreatment ¹⁸F-FDG PET. The predictive value of the SUVmax of the primary tumor (SUVmax-t) and regional lymph nodes (SUVmax-n) was evaluated using probability density functions. Receiver operating characteristic curves were used to determine optimal cutoffs for the SUVmax-n/SUVmax-t ratio (NTR). Kaplan-Meier and Cox regression analyses were used to assess survival.<h4>Results</h4>The optimal SUVmax-t and SUVmax-n cutoffs were 7.5 and 6.9, respectively. High SUVmax-t and SUVmax-n were related to local and regional recurrence, respectively. Patients with low SUVmax had better 3-year overall survival (OS). To avoid cross-sensitization of cutoff points, we stratified patients with high SUVmax into the low and high NTR groups. The 3-year distant metastasis-free survival (DMFS; 92.3 vs. 80.6%, P = 0.009), progression-free survival (PFS; 84.0 vs. 67.7%, P = 0.011), and OS (95.9 vs. 89.2%, P = 0.002) significantly differed between the high vs. low NTR groups for patients with high SUVmax. Multivariable analysis showed that NTR was an independent prognostic factor for DMFS (hazard ratio [HR]: 2.037, 95% CI: 1.039-3.992, P = 0.038), PFS (HR: 1.636, 95% CI: 1.021-2.621, P = 0.041), and OS (HR: 2.543, 95% CI: 1.214-5.325, P = 0.013).<h4>Conclusion</h4>High SUVmax was associated with NPC recurrence. NTR is a potential prognosticator for DMFS, suggesting that heterogeneity in the pretreatment ¹⁸F-FDG uptake between the primary tumor and lymph nodes is associated with high invasion and metastatic potential.BMC cancer495https://www.ebi.ac.uk/biostudies/studies/S-EPMC9069730biostudies-literatureReflecting on the utility of standardized uptake values on ¹⁸F-FDG PET in nasopharyngeal carcinoma.PMC9069730Zheng YHuang CLiu JYou ZHu YLiang ZChen CLi LFei ZXie SWu HQiu XYi LXu TfalseReflecting on the utility of standardized uptake values on ¹⁸F-FDG PET in nasopharyngeal carcinoma.<h4>Background</h4>To rethink the clinical significance of standardized uptake values (SUVs) of nasopharyngeal carcinoma (NPC) on ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron-emission tomography (PET).<h4>Methods</h4>We retrospectively reviewed 369 NPC patients who underwent pretreatment ¹⁸F-FDG PET. The predictive value of the SUVmax of the primary tumor (SUVmax-t) and regional lymph nodes (SUVmax-n) was evaluated using probability density functions. Receiver operating characteristic curves were used to determine optimal cutoffs for the SUVmax-n/SUVmax-t ratio (NTR). Kaplan-Meier and Cox regression analyses were used to assess survival.<h4>Results</h4>The optimal SUVmax-t and SUVmax-n cutoffs were 7.5 and 6.9, respectively. High SUVmax-t and SUVmax-n were related to local and regional recurrence, respectively. Patients with low SUVmax had better 3-year overall survival (OS). To avoid cross-sensitization of cutoff points, we stratified patients with high SUVmax into the low and high NTR groups. The 3-year distant metastasis-free survival (DMFS; 92.3 vs. 80.6%, P = 0.009), progression-free survival (PFS; 84.0 vs. 67.7%, P = 0.011), and OS (95.9 vs. 89.2%, P = 0.002) significantly differed between the high vs. low NTR groups for patients with high SUVmax. Multivariable analysis showed that NTR was an independent prognostic factor for DMFS (hazard ratio [HR]: 2.037, 95% CI: 1.039-3.992, P = 0.038), PFS (HR: 1.636, 95% CI: 1.021-2.621, P = 0.041), and OS (HR: 2.543, 95% CI: 1.214-5.325, P = 0.013).<h4>Conclusion</h4>High SUVmax was associated with NPC recurrence. NTR is a potential prognosticator for DMFS, suggesting that heterogeneity in the pretreatment ¹⁸F-FDG uptake between the primary tumor and lymph nodes is associated with high invasion and metastatic potential.2022-01-01T00:00:00Z2022 May2026-05-30T20:59:07.436Z2025-04-04T10:01:50.589ZS-EPMC90697303551380410.1186/s12885-022-09626-w