Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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A correlation between comprehensive neck dissection and increased uptake around the sternoclavicular joint on post-operative 18F-FDG PET/CT

경부절제술과 술후 시행된 PET/CT상의 흉쇄관절 섭취 증가의 상관관계 분석

  • Oh, So Won (Department of Nuclear medicine, Boramae Medical Center, Seoul National University College of Medicine) ;
  • Lee, Doh Young (Department of Otorhinolaryngology-Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine) ;
  • Kim, Bo Hae (Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk Unversity Gyeongju Hospital) ;
  • Kim, Kwang Hyun (Department of Otorhinolaryngology-Head and Neck Surgery, Bundang Jesaeng Hospital) ;
  • Kim, Yu Kyeong (Department of Nuclear medicine, Boramae Medical Center, Seoul National University College of Medicine) ;
  • Jung, Young Ho (Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital)
  • 오소원 (서울대학교 의과대학 보라매병원 핵의학과) ;
  • 이도영 (서울대학교 의과대학 보라매병원 이비인후과) ;
  • 김보해 (동국대학교 경주병원 이비인후과) ;
  • 김광현 (분당제생병원 이비인후과) ;
  • 김유경 (서울대학교 의과대학 보라매병원 핵의학과) ;
  • 정영호 (분당서울대학교병원 이비인후과)
  • Received : 2018.04.16
  • Accepted : 2018.05.14
  • Published : 2018.05.30
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Abstract

Background/Objectives: This study aimed to evaluate the changes of uptake around the sternoclavicular joint (SCJ) according to 18F-FDG PET images in patients with head and neck cancer who underwent neck dissection. Materials & Methods: Retrospectively, the medical records of patients who received selective or comprehensive neck dissection were reviewed. Preoperative and 1-year postoperative 18F-FDG PET images, if available, were analyzed by nuclear medicine physicians in both qualitative and quantitative manners. Correlation between the changes of uptake around SCJ and perioperative data were statistically analyzed. Results: Thirty-seven patients satisfying the inclusion criteria were enrolled. Seven patients with increased uptake around SCJ on 1-year postoperative 18F-FDG PET showed a correlation with radical or comprehensive neck dissection, accessory nerve sacrifice, and high postoperative SUVmax. When 20 patients with increased uptake around SCJ according to quantitative measurement were compared with other patients without increased uptake, no parameter was significantly different, except postoperative SUVmax. Bivariate logistic regression analysis revealed that the clinical symptom (shoulder or sternal pain) was significantly correlated with the extent of neck dissection (OR 0.227, CI 0.053-0.966, p=0.045) and spinal accessory nerve sacrifice (OR 13.500, CI 1.189-153.331, p=0.036). Conclusions: Increased uptake around SCJ on 1-year postoperative 18 F-FDG PET was correlated with either the radical or comprehensive procedure, as well as with accessory nerve sacrifice. This suggests that subjective analysis of 18F-FDG PET can be used to detect subclinical shoulder instability.

Keywords

References

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