Browse > Article

Comparison of $^{18}F$ FDG-PET and CT/MRI for the Diagnosis of Cervical Lymph Node Metastasis in Head and Neck Cancer: A Level-by-Level Based Study  

Yang, Yoo-Jung (Departments of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Kim, Jae-Seung (Departments of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Kim, Sang-Yun (Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine)
Lee, Ho-Gyu (Departments of Radiology, Asan Medical Center, University of Ulsan College of Medicine)
Nam, Soon-Yul (Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine)
Choi, Seung-Ho (Departments of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine)
Ryu, Jin-Sook (Departments of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Yeo, Jeong-Seok (Departments of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Moon, Dae-Hyuk (Departments of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine)
Publication Information
The Korean Journal of Nuclear Medicine / v.38, no.1, 2004 , pp. 52-61 More about this Journal
Abstract
Purpose: Cervical lymph node metastasis is the most important factor of the prognosis and therapeutic planning in head and neck cancer. With increasing interest of minimally invasive neck surgery, more accurate preoperative assessment of cervical lymph node becomes more essential. We evaluated the diagnostic accuracy of $^{18}F$ FDG-PET in the assessment of lymph node metastasis in patients with primary head and neck cancer and compared the results with those of CT/MRI. Materials and Methods: Thirty-two patients (M/F=27/5, $56{\pm}10yr$) with biopsy proven head and neck cancer (16 supraglottic cancer, 9 tongue cancer, 7 others) underwent FDG-PET and CT/MRI (25/7) within 1 month before neck dissection. Based on lymph node level, the diagnostic sensitivity and specificity of FDG PET and CT/MRI for the metastasis of cervical lymph node were compared. Results: Of 153 lymph node levels dissected in 32 patients, 32 lymph node levels of 19 patients were positive for metastasis by histopatholologic examination. The overall sensitivity and specificity of FDG-PET were 88% (28/32) and 93% (113/121), whereas those of CT/MRI were 56% (18/32) (p=0.002) and 92% (112/121), respectively. The diagnostic sensitivity and specificity of FDG-PET were different according to location of lymph node levels, and those of ipsilateral level 11 were lower than those of other levels. Conclusion: FDG-PET is more sensitive in detecting metastatic cervical lymph node in head and neck cancer than CT/MRI. FDG-PET might be useful in guiding the extent of neck dissection.
Keywords
Head and neck cancer; FDG-PET; CT; Lymph node metastasis;
Citations & Related Records
연도 인용수 순위
  • Reference
1 England RJ, Stafford ND. Conservative neck surgery in squamous cell carcinoma. Surg Oncol 1998;7: 91-4   DOI   ScienceOn
2 Wong WL, Chevretton EB, McGurk M, Hussain K, Davis J, Beaney R, et al. A prospective study of PET-FDG imaging for the assessment of head and neck squamous cell carcinoma. Clin Otolaryngol. 1997;22:209-14
3 Wong RJ, Rinaldo A, Ferlito A, Shah JP. Occult cervical metastasis in head and neck cancer and its impact on therapy. Acta Otolaryngol 2002;122:107-14   PUBMED
4 Nowak B, Martino E, Janicke S, Cremerius U, Adam G, Zimny M, et al. Diagnostic evaluation of malignant head and neck cancer by $^{18}$F-FDG PET compared to CT/MRI. Nuklearmedizin 1999;38:312-8   PUBMED
5 Benchaou M, Lehmann W, Slosman DO, Becker M, Lemoine R, Rufenacht D, et al. The role of FDG-PET in the preoperative assessment of N-staging in head and neck cancer. Acta otolaryngol 1966;116:332-5
6 Albuquerque K, Cirrone J, Aziz H, Har-El G, Sundaram K, Dipillo F, et al. Quality of life with functional pharyngeal preservation in advanced carcinomas of the base tongue complex using an integrated trimodality approach. Am J Clin Oncol 2001;24:623-7   DOI   ScienceOn
7 Robbins KT, Clayman G, Levine PA, Medina J, Sessions R, Shaha A. Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg 2002;128: 751-8   PUBMED
8 Ferlito A, Shaha AR, Rinaldo A. Evolution in the philosophy of neck dissection. Acta Otolaryngol 2001;121:963-6   DOI   PUBMED
9 Robbins KT, Atkinson JL, Byers RM, Cohen JI, Lavertu P, Pellitteri P. The use and misuse of neck dissection for head and neck cancer. J Am Coll Surg 2001;193:91-102   DOI   ScienceOn
10 Shah JP, Lydiatt W. Treatment of cancer of the head and neck. CA Cancer J Clin 1995;45:352-68   DOI   ScienceOn
11 Zhuang H, Pourdehnad M, Lambright ES, Yamamoto AJ, Lanuti M, Li P. Dual time point 18F-FDG PET imaging for differentiating malignant from inflammatory processes. J Nucl Med 2001;42: 1412-7   PUBMED
12 Hannah A, Scott AM, Tochon-Danguy H, Chan JG, Akhurst T, Berlangieri S. Evaluation of 18F-Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography With Histopathologic Correlation in the Initial Staging of Head and Neck Cancer. Ann Surg 2002;236:208-17   DOI   ScienceOn
13 Andersen PE, Shah JP, Cambronero E, Spiro RH. The role of comprehensive neck dissection with preservation of the spinal accessory nerve in the clinically positive neck. Am J Surg 1994;168: 499-502   DOI   ScienceOn
14 Manolidis S, Donald PJ, Volk P, Pounds TR. The use of positron emission tomography scanning in occult and recurrent head and neck cancer. Acta Otolaryngol 1998;Suppl 534
15 Paulus P, Sambon A, Vivegnis D, Hustinx R, Moreau P, Collignon J. FDG-PET for the assessment of primary head and neck tumors: clinical, computed tomography, and histopathological correlation in 38 patients. Laryngoscope 1998;108:1578-83   DOI   ScienceOn
16 Rege S, Maass A, Chaiken L, Hoh CK, Choi Y, Lufkin R, et al. Use of positron emission tomography with fluorodeoxyglucose in patients with extracranial head and neck cancers. Cancer 1994;73:3047-58   DOI   ScienceOn
17 van den Brekel MW, Stel HV, Castelijns JA, Nauta JJ, van der Waal I, Valk J. Cervical lymph node metastasis: assessment of radiologic criteria. Radiology 1990;177:379-84   PUBMED
18 Kostakoglu L, Agress H, Goldsmith SJ. Clinical role of FDG PET in evaluation of cancer patients. Radiographics 2003;23:315-340   DOI   ScienceOn
19 Ferlito A, Robbins KT, Shaha AR, Pellitteri PK, Kowalski LP, Gavilan J, et al. Current considerations in neck dissection. Acta Otolaryngol 2002;122:323-9   DOI   ScienceOn
20 Stokkel MP, ten Broek FW, Hardijk G, Koole R, van Rijk PP. Preoperative evaluation of patients with primary head and neck cancer using dual-head $^{18}$Fluorodeoxyglucose positron emission tomography. Ann Surg 2000;231:229-34   DOI   ScienceOn
21 Goerres GW, Hany TF, Kamel E, Schulthess GK, Buck A. Head and neck imaging with PET and PET/CT: artifacts from dental metallic implants. Eur J Nucl Med 2002;29:367-370   DOI   ScienceOn
22 Ferlito A, Mannara GM, Rinaldo A, Politi M, Robiony M, Costa F. Is extended selective supraomohyoid neck dissection indicated for treatment of oral cancer with clinically negative neck? Acta Otolaryngol 2000;120:792-5
23 Braams JW, Pruim J, Freling NJM, Nikkels PGJ, Roodenburg JLN, Boering G, et al. Detection of lymph node metastases of squamous cell cancer of the head and neck with FDG-PET and MRI. J Nucl Med 1995;36:211-216   PUBMED
24 Snow GB, Patel P, Leemans CR, Tiwari R. Management of cervical lymph nodes in patients with head and neck cancer. Eur Arch Otorhinolaryngol 1992;249:187-94   PUBMED
25 Ferlito A, Buckley JG, Shaha AR, Silver CE, Rinaldo A, Kowalski L. The role of neck dissection in the treatment of supraglottic laryngeal cancer. Acta Otolaryngol 2001;121:448-53   DOI   ScienceOn
26 Adams S, Baum RP, Stuckensen T, Bitter K, Hor G. Prospective comparison of $^{18}$F-FDG PET with conventional imaging modalities (CT, MRI, US) in lymph node staging of head and neck cancer. Eur J Nucl Med 1998;25:1255-60   DOI   ScienceOn
27 Wolf GT, Fisher SG. Effectiveness of salvage neck dissection for advanced regional metastases when induction chemotherapy and radiation are used for organ preservation. Laryngoscope 1992;102:934-9   DOI   ScienceOn
28 Ferlito A, Buckley JG, Shaha AR, Rinaldo A. Contemporary important considerations in diagnosis and treatment of head and neck cancer. Acta Otolaryngol 2002;122:115-20   DOI   ScienceOn