Clinical values for abnormal18F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma
- Clinical values for abnormal18F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma
- Hwan Seo Lee; Jae Seung Kim; Jong-Lyel Roh; Seung-Ho Choi; Soon Yuhl Nam; 김상윤
- Squamous cell carcinoma; Head and neck; 18F-FDG uptake; PET/CT; Second cancer
- Issue Date
- European journal of radiology
- VOL 83, NO 8, 1455-1460
- Purpose: Fluorine 18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computedtomography (CT) is used to identify index or second primary cancer (SP) of the head and neck (HN)through changes in18F-FDG uptake. However, both physiologic and abnormal lesions increase18F-FDGuptake. Therefore, we evaluated18F-FDG uptake in the HN region to determine clinical values of abnormaltracer uptake.
Methods: A prospective study approved by the institutional review board was conducted in 314 patientswith newly diagnosed HN squamous cell carcinoma (HNSCC) and informed consent was obtained from allenrolled patients. The patients received initial staging workups including18F-FDG PET/CT and biopsies. Alllesions with abnormal HN18F-FDG uptake were recorded and most of those were confirmed by biopsies.Diagnostic values for abnormal18F-FDG uptake were calculated.
Results: Abnormal18F-FDG uptake was identified in primary tumors from 285 (91.9%) patients. False-negative results were obtained for 22.3% (23/103) T1 tumors and 2.2% (2/93) T2 tumors (P < 0.001). Thirty-eight regions of abnormal18F-FDG uptake were identified in 36 (11.5%) patients: the thyroid (n = 13),maxillary sinus (n = 7), palatine tonsil (n = 6), nasopharynx (n = 5), parotid gland (n = 2) and others (n = 5).Synchronous SP of the HN was identified in eight (2.5%) patients: the thyroid (n = 5), palatine tonsil (n = 2),and epiglottis (n = 1). The sensitivity and specificity of18F-FDG PET/CT for identification of SPs were 75.0%and 98.7%, respectively.
Conclusions:18F-FDG PET/CT is a reliable method for tumor staging and identify SP in HN region, promotingappropriate therapeutic planning. Additional examinations may be required to identify superficial orsmall-volume tumors.
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