{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:20Z","timestamp":1789535060468,"version":"build-2803163510"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Head and neck cancer is a disease with a tendency for recurrence and metastases even after treatment. Late detection leads to poor patient outcomes. One promising diagnostic tool is FDG-PET\/CT which can detect both, morphological and metabolic evidence of malignant diseases. A common measure is SUVmax, the maximum standardized uptake value in a lesion. The objective of this study is to evaluate the prognostic value of post-treatment FDG-PET\/CT in patients with head and neck squamous cell carcinoma (HNSCC), focusing on the association of SUVmax and scan timing with progression-free survival (PFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 84 patients with HNSCC treated with definitive radiotherapy between 2016 and 2023 at a German university hospital. All patients underwent at least one post-radiotherapy FDG-PET\/CT scan. All post radiation scans that were performed before or no later than one month after documented disease progression were included for prognostic analysis. SUVmax values were categorized into three groups: (1) physiological uptake (no suspicious lesion, no SUVmax value recorded, and radiological report consistent with post-therapeutic changes), (2) intermediate uptake (SUVmax &amp;gt;1 but &amp;lt;7.5), and (3) high uptake (SUVmax \u22657.5). PET\/CT timing was stratified as early (\u22643 months) or delayed (&amp;gt;3 months) after radiotherapy. Diagnostic performance metrics and survival outcomes were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 88 post-treatment PET\/CT scans were evaluated. Mean follow up was 27.7 months. Disease progression occurred in 33 patients and 10 patients died during follow-up. SUVmax \u22657.5 was significantly associated with shorter PFS (p &amp;lt; 0.05). Intermediate SUVmax values also predicted increased progression risk compared to physiological uptake. The optimal diagnostic performance was achieved with delayed PET\/CT (&amp;gt;3 months), particularly using a low SUVmax threshold (&amp;gt;1), which yielded high sensitivity (90.9%) and negative predictive value (88.9%). Multivariate analysis confirmed SUVmax as an independent predictor of PFS (HR: 1.21; 95% CI: 1.11-1.32; p &amp;lt; 0.001), alongside male sex and oral cavity primary site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Post-treatment FDG-PET\/CT is a valuable prognostic tool in HNSCC follow-up. SUVmax, especially when evaluated after three months, is predictive of disease progression. Integrating PET\/CT into routine surveillance may improve risk stratification and inform tailored follow-up intensity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1923156","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:30:47Z","timestamp":1789533047000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic significance of intermediate and high SUVmax values and imaging timing on FDG-PET\/CT after radiation therapy in HNSCC: a retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Thomas","family":"Hebisch","sequence":"first","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"Department of Radiotherapy and Radiation Oncology, Philipps-Universit\u00e4t Marburg","place":["Marburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerem Tuna","family":"Tas","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"Department of Radiotherapy and Radiation Oncology, Philipps-Universit\u00e4t Marburg","place":["Marburg, Germany"]},{"name":"Marburg Ion-Beam Therapy Center (MIT), Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"University Cancer Center (UCT) Frankfurt - Marburg","place":["Marburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Lishewski","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"Department of Radiotherapy and Radiation Oncology, Philipps-Universit\u00e4t Marburg","place":["Marburg, Germany"]},{"name":"Marburg Ion-Beam Therapy Center (MIT), Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"University Cancer Center (UCT) Frankfurt - Marburg","place":["Marburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima Frosan","family":"Sheikhzadeh","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"Department of Radiotherapy and Radiation Oncology, Philipps-Universit\u00e4t Marburg","place":["Marburg, Germany"]},{"name":"Marburg Ion-Beam Therapy Center (MIT), Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"University Cancer Center (UCT) Frankfurt - Marburg","place":["Marburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klemens","family":"Zink","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"Department of Radiotherapy and Radiation Oncology, Philipps-Universit\u00e4t Marburg","place":["Marburg, Germany"]},{"name":"Marburg Ion-Beam Therapy Center (MIT), Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"University Cancer Center (UCT) Frankfurt - Marburg","place":["Marburg, Germany"]},{"name":"LOEWE Research Cluster for Advanced Medical Physics in Imaging and Therapy (ADMIT), Technische Hochschule (TH) Mittelhessen University of Applied Sciences","place":["Giessen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boris A.","family":"Stuck","sequence":"additional","affiliation":[{"name":"University Cancer Center (UCT) Frankfurt - Marburg","place":["Marburg, Germany"]},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universit\u00e4t Marburg","place":["Marburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilke","family":"Vorwerk","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"Department of Radiotherapy and Radiation Oncology, Philipps-Universit\u00e4t Marburg","place":["Marburg, Germany"]},{"name":"Marburg Ion-Beam Therapy Center (MIT), Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"University Cancer Center (UCT) Frankfurt - Marburg","place":["Marburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Adeberg","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"Department of Radiotherapy and Radiation Oncology, Philipps-Universit\u00e4t Marburg","place":["Marburg, Germany"]},{"name":"Marburg Ion-Beam Therapy Center (MIT), Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"University Cancer Center (UCT) Frankfurt - Marburg","place":["Marburg, Germany"]},{"name":"LOEWE Research Cluster for Advanced Medical Physics in Imaging and Therapy (ADMIT), Technische Hochschule (TH) Mittelhessen University of Applied Sciences","place":["Giessen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Gawish","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiation Oncology, Marburg University Hospital","place":["Marburg, Germany"]},{"name":"Department of Radiotherapy and Radiation Oncology, Philipps-Universit\u00e4t 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