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Utility of FDG PET-CT Scans on Nodal Staging of Squamous Cell Carcinoma in the Oral Cavity and Oropharynx  

Joo, Young-Hoon (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea)
Sun, Dong-Il (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea)
Park, Jun-Ook (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea)
Yoo, Ie-Ryung (Department of Nuclear Medicine, College of Medicine, The Catholic University of Korea)
Kim, Min-Sik (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea)
Publication Information
Korean Journal of Head & Neck Oncology / v.26, no.1, 2010 , pp. 14-18 More about this Journal
Abstract
Objectives : We evaluated the use of FDG PET/CT for the identification of cervical nodal metastases of SCC of the oral cavity and oropharynx with histological correlation. Material and Methods : We reviewed 46 medical records, from January 2004 to July 2007, of patients who underwent FDG PET/CT and CT/MRI for SCC of the oral cavity and oropharynx before surgery. We recorded the lymph node metastases according to the neck level affected and the system used for the imaging-based nodal classification. Results : The FDG PET/CT had a sensitivity of 75.6% and a specificity of 96.7% ; it had a higher sensitivity than the CT/MRI for identification of cervical metastases on the side of the neck(26/28 vs. 20/28, p=0.031) and at each of the cervical levels(34/45 vs. 26/45, p=0.008). There was a significant difference in the $SUV_{max}$ between the benign and malignant cervical lymph nodes($3.31{\pm}3.23$ vs. $4.22{\pm}2.57$, p=0.028). The receiver-operating-characteristic (ROC) curve analysis for differentiating the benign from the malignant cervical lymph nodes, showed that the area under the curve(AUC) of the FDG PET/CT was 0.775. The cut-off value for the $SUV_{max}$ was 2.23 based on the ROC curve. There was a significant correlation between the $SUV_{max}$ and the size of the cervical lymph nodes(Spearman r=0.353, p=0.048). Conclusion : FDG PET/CT images were more accurate than the CT/MRI images. In addition, the $SUV_{max}$ cut-off values were important for evaluating cervical the cervical nodes in the patients with SCC of the oral cavity and oropharynx.
Keywords
Carcinoma; squamous cell; Mouth; Oropharynx; Lymphatic metastasis; Positron-emission tomography;
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