European journal of nuclear medicine and molecular imaging · 2026
Delayed total-body [18F]FDG PET/CT demonstrates systemic vascular inflammation after concurrent chemoradiotherapy in patients with head and neck cancer.
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Liu Guobing, Abdelhafez Yasser G, Mehadji Brahim, Di Franco Martina, Spencer Benjamin A, Li Siqi, Sen Fatma, Sun Jinger Yu, Rao Shyam, Alavi Abass, Shi Hongcheng, Wang Guobao, Nardo Lorenzo
Аннотация
PURPOSE: To investigate the feasibility of 2-h-delayed total-body [18F]FDG PET/CT for detecting vascular inflammation after concurrent chemoradiotherapy (CCRT) in head-and-neck-cancer (HNC) patients and to exploratorily assess its association with cardiovascular-related events (CVRE).
METHODS: Twenty-four HNC patients underwent 2-h total-body [18F]FDG PET/CT before and 3 months after CCRT and were followed for CVRE. Vascular inflammation was evaluated across eleven arterial segments. Slice-based mean standardized uptake values (SUVmean) were normalized to the superior vena cava (SVC) to derive the target-to-background ratio (TBRmean), and segmental averages (avgTBRmean) were calculated. Pre- and post-CCRT avgTBRmean were compared, and the relative difference (RD-avgTBRmean) was analyzed for association with radiation dose and CVRE.
RESULTS: Post-CCRT PET demonstrated increased avgTBRmean in all arterial segments, with significant increases in the carotid arteries (left: 1.32 vs 1.20, P < 0.001; right: 1.34 vs 1.24, P = 0.018), subclavian arteries (left: 1.20 vs 1.14, P = 0.022; right: 1.18 vs 1.10, P = 0.019), and infrarenal abdominal aorta (1.08 vs 0.96, P < 0.001). Mean radiotherapy dose correlated with both post-CCRT avgTBRmean (r = 0.289, P = 0.002) and RD-avgTBRmean (r = 0.251, P = 0.008). Patient-based average RD-avgTBRmean was higher in patients with CVRE (12.1% ± 6.7% vs. 4.5% ± 6.5%, P = 0.032). However, no independent association remained after age adjustment. The SUVmean of SVC was comparable between pre- and post-CCRT PET.
CONCLUSION: Delayed total-body [18F]FDG PET/CT demonstrated CCRT-related vascular inflammation in HNC patients, suggesting a potential imaging biomarker of treatment-related cardiovascular risk but warrants validation in larger studies.
METHODS: Twenty-four HNC patients underwent 2-h total-body [18F]FDG PET/CT before and 3 months after CCRT and were followed for CVRE. Vascular inflammation was evaluated across eleven arterial segments. Slice-based mean standardized uptake values (SUVmean) were normalized to the superior vena cava (SVC) to derive the target-to-background ratio (TBRmean), and segmental averages (avgTBRmean) were calculated. Pre- and post-CCRT avgTBRmean were compared, and the relative difference (RD-avgTBRmean) was analyzed for association with radiation dose and CVRE.
RESULTS: Post-CCRT PET demonstrated increased avgTBRmean in all arterial segments, with significant increases in the carotid arteries (left: 1.32 vs 1.20, P < 0.001; right: 1.34 vs 1.24, P = 0.018), subclavian arteries (left: 1.20 vs 1.14, P = 0.022; right: 1.18 vs 1.10, P = 0.019), and infrarenal abdominal aorta (1.08 vs 0.96, P < 0.001). Mean radiotherapy dose correlated with both post-CCRT avgTBRmean (r = 0.289, P = 0.002) and RD-avgTBRmean (r = 0.251, P = 0.008). Patient-based average RD-avgTBRmean was higher in patients with CVRE (12.1% ± 6.7% vs. 4.5% ± 6.5%, P = 0.032). However, no independent association remained after age adjustment. The SUVmean of SVC was comparable between pre- and post-CCRT PET.
CONCLUSION: Delayed total-body [18F]FDG PET/CT demonstrated CCRT-related vascular inflammation in HNC patients, suggesting a potential imaging biomarker of treatment-related cardiovascular risk but warrants validation in larger studies.