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Usefulness of $^{18}F-FDG$ PET/CT in the Diagnosis of Cervical Lymph Node Metastases of Head and Neck Cancer  

Kim, Chung-Ho (Department of Radiology, College of Medicine, Catholic University of Korea)
Kim, Sung-Hoon (Department of Radiology, College of Medicine, Catholic University of Korea)
O, Joo-Hyun (Department of Radiology, College of Medicine, Catholic University of Korea)
Yoo, Ie-Ryung (Department of Radiology, College of Medicine, Catholic University of Korea)
Chung, Yong-An (Department of Radiology, College of Medicine, Catholic University of Korea)
Park, Young-Ha (Department of Radiology, College of Medicine, Catholic University of Korea)
Sohn, Hyung-Sun (Department of Radiology, College of Medicine, Catholic University of Korea)
Lee, Sung-Young (Department of Radiology, College of Medicine, Catholic University of Korea)
Chung, Soo-Kyo (Department of Radiology, College of Medicine, Catholic University of Korea)
Publication Information
The Korean Journal of Nuclear Medicine / v.39, no.5, 2005 , pp. 269-277 More about this Journal
Abstract
Purpose: This study evaluated the diagnostic value of $^{18}F-FDG$ PET/CT in detecting cervical lymph node metastases in head and neck cancer patients. Materials & Methods: The patients were divided into two groups, 46 patients underwent PET/CT scan for initial staging before surgery, and 20 patients for restaging of recurrence after primary treatment. Increased FDG uptakes in cervical lymph nodes were evaluated retrospectively and correlated with the histopathologic results. Results: In the initial staging group, 21 lymph nodes were detected by PET/CT in 15 patients. 20 lymph nodes were confirmed as metastases with a mean peak SUV of 5.84, and the remaining one lymph node was an inflammatory lesion, with a peak SUV of 2.75. Seven metastatic lymph nodes were reported only by histopatholoay. The sensitivity, specificity, positive predictive value and negative predictive value were 74.0%, 99.6%, 95.2% and 97.3%, respectively. In the recurrence group, 11 lymph nodes were detected in 9 patients, and 8 nodes were true positive, with a mean peak SUV of 5.65. The other three were inflammatous lymph nodes, and the peak SUVs were 2.16, 2.94 and 3.53. One false negative lymph node was reported. The sensitivity, specificity, positive predictive value and negative predictive value were 88.8%, 97.7%, 72.7% and 92.9%, respectively. Conclusions: FDG-PET/CT shows higher positive predictive value in the initial staging group, and better sensitivity in the recurrence group. Therefore PET/CT could be useful for both initial staging and restaging of recurrent cervical lymph node metastases.
Keywords
Head and neck cancer; F-18-FDG PET/CT; Cervical lymph node metastasis;
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