Diagnostic Value of FDG-PET/CT for the Identification of Extranodal Extension in Patients With Head and Neck Squamous Cell Carcinoma

Abstract

Background/Aim: We evaluated the diagnostic value of functional imaging with [ 18 F]-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography/computed tomography (PET/CT) for the identification of extranodal extension (ENE) in patients with head and neck squamous cell carcinoma (HNSCC). Patients and Methods: In this study, 94 patients with HNSCC who underwent FDG-PET/CT were enrolled. We recorded the maximum standardized uptake value (SUV max), compared the results with pathologic findings, and evaluated the diagnostic performance of using a SUV max cutoff value for ENE. Results: Of the 566 dissected levels examined, 53 (9.4%) exhibited ENE. The mean SUV max of LN with and without ENE were 6.67 and 1.64, respectively (p<0.001). A receiver operating characteristics (ROC) curve analysis for SUV max showed an area under the ROC curve of 0.913. A SUV max cutoff of 3.0 achieved diagnostic performance for identifying ENE with sensitivity, specificity, and accuracy of 81.1%, 94.3% and 93.1%, respectively. Conclusion: FDG-PET/CT findings using a SUV max cutoff of 3.0 provides appropriate diagnostic value in identifying ENE.

Hypofractionated palliative volumetric modulated arc radiotherapy with the Radiation Oncology Study Group 8502 “QUAD shot” regimen for incurable head and neck cancer

“…Patients were simulated with planning computed tomography (CT) imaging in a dedicated thermoplastic head and neck mask for immobilization prior to each RT cycle. Gross tumor volume (GTV) included primary tumor and lymph node metastases; it is defined based on the fiber scope, contrast-enhanced CT images, and magnetic resonance (MR) imaging with or without [ 18 F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET)/CT [12,13]. A clinical target volume margin of 5 mm was added to the GTV for subclinical invasion.…”

Diagnostic Accuracy of Combined PET/CT with MRI, 18F-FDG PET/MRI, and 18F-FDG PET/CT in Patients with Oropharyngeal and Hypopharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

“…A possible explanation for this different statistic is the classification of patients with head and neck tumors of different areas in one group. From the previously mentioned data, the prevalence of synchronous cancers/distant metastases seems to be more in patients with oropharyngeal and hypopharyngeal squamous cell carcinomas compared with patients with oral cavity cancers [ 39 ]. The overall prevalence of distant metastases and synchronous cancer in patients with oropharyngeal and hypopharyngeal squamous cell carcinomas was 9.2% (95% CI: 6, 12.5) and 11.8% (95% CI: 8.2, 15.5), respectively, with the esophagus (4.6%) being the most common site of synchronous cancer.…”

Concurrent Chemoradiotherapy With Docetaxel, Cisplatin, and 5-Fluorouracil for T3 N0 Glottic Carcinoma Without Vocal Cord Fixation

“…Pretreatment examination included physical, endoscopic, and ultrasonographic exminations with or without fine-needle aspiration cytology specimens in addition to MR imaging with or without gadolinium-based contrast agents. Whole-body CT imaging with or without [ 18 F]-fluoro-2-deoxy-D-glucose positron emission tomography was also performed (10). The tumors were staged in accordance with the sixth to eighth edition of the UICC TNM staging system.…”