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Objectives FDG-PET/CT is widely use for initial staging and recurrence of HNSCC.Its prognostic value has already been shown particularly tumoral SUVmax measured at initial staging is without real established cut-off (4 to 10 within different series).The objective of this study was to determine complementary and independent prognostic value of the early and late intratumoral kinetic uptake of tracer in FDG-PET/CT in comparison with usual prognostic factors.Materials and methods Patients referred to our department to perform FDG-PET/CT in staging of HNSCC were prospectively evaluated.An early dynamic acquisition (List-Mode) for 60min and a static cervical acquisition step at 2h were performed in addition to whole-body imaging.The initial slope of FDG uptake (C0.k) was determined according to hypothesis Patlak two-compartment (without output) model acquisition, k corresponding to the diffusion coefficient.A △SUVmax(1-2h) was measured for each exam by dual time point method.Event free survival (EFS) and overall survival (OS) was determined by Kaplan Meier method and compared to kinetic parameters in univafiate and multivariate analysis, including usual prognostic factors: age, sex, primary site, AJCC stage.Résults 66 consecutive patients (60M/6F) (mean sd age;61 9 yo) were included.In univariate analysis, besides age and stage, △SUVmax(1-2h) was predictive of EFS (p=0.002) and OS (p<0.001) whereas initial slope (C0.k) was predictive of EFS (p=0.02).In multivariate analysis, △SUVmax(1-2h) persisted as an independent predictive factor for EFS (p=0.02) and OS (p=0.005) and C0.k for EFS (p=0.04).A k, modeling a slow initial slope of FDG uptake (low C0.k) and a late persistent perfusion (high △SUVmax1-2h), was also a factor of poor prognosis.Conclusions Our results suggest an additional prognostic interest of intratumoral kinetic uptake of tracer in FDGPET/CT, independently of usual prognostic factors in patients with HNSCC.