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Accuracy of F-18 FDG PET/CT in Preoperative Assessment of Cervical Lymph Nodes in Head and Neck Squamous Cell Cancer: Comparison with CT/MRI  

Choi, Seung-Jin (Departments of Nuclear Medicine, Inha University College of Medicine)
Byun, Sung-Su (Departments of Radiology, Inha University College of Medicine)
Park, Sun-Won (Departments of Radiology, Inha University College of Medicine)
Kim, Young-Mo (Departments of Otolaryngology, Inha University College of Medicine)
Hyun, In-Young (Departments of Nuclear Medicine, Inha University College of Medicine)
Publication Information
Nuclear Medicine and Molecular Imaging / v.40, no.6, 2006 , pp. 309-315 More about this Journal
Abstract
Purpose: Accurate evaluation of cervical lymph node (LN) metastasis of head and neck squamous cell canter (SCC) is important to treatment planning. We evaluated the diagnostic accuracy of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of cervical LN metastasis of head and neck SCC and performed a retrospective comparison with CT/MRI findings. Materials & Methods: Seventeen patients with pathologically proven head and neck SCC underwent F-18 FDG PET/CT and CT/MRI within 4 week before surgery. We recorded lymph node metastases according to the neck level system of imaging-based nodal classification. F-18 FDG PET/CT images were analyzed visually for assessment of regional tracer uptake in LN. We analyzed the differences in sensitivity and specificity between F-18 FDG PET/CT and CT/MRI using the Chi-square test. Results: Among the 17 patients, a total of 123 LN levels were dissected, 29 of which showed metastatic involvement. The sensitivity and specificity of F-18 FDG PET/CT for detecting cervical LN metastasis on a level-by-level basis were 69% (20/29) and 99% (93/94). The sensitivity and specificity of CT/MRI were 62% (18/29) and 96% (90/94). There was no significant difference in diagnostic accuracy between F-18 FDG PET/CT and CT/MRI. Interestingly, F-18 FDG PET/CT detected double primary tumor (hepatocellular carcinoma) and rib metastasis, respectively. Conclusion: There was not statistically significant difference of diagnostic accuracy between F-18 FDG PET/CT and CT/MRI for the detection of cervical LN metastasis of head and neck SCC. The low sensitivity of F-18 FDG PET/CT was due to limited resolution for small metastatic deposits.
Keywords
head and neck neoplasms; F-18 fluorodeoxyglucose; positron emission tomography; lymph nodes; neck; neoplasm metastasis;
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