Effectiveness of PET/CT in the preoperative evaluation of neck disease

Nguyen, Anthony; Luginbuhl, Adam; Cognetti, David M.; Abel, Katie Van; Bar‐Ad, Voichita; Intenzo, Charles; Keane, William M.; Curry, Joseph M.

doi:10.1002/lary.24329

Cited by 27 publications

(55 citation statements)

References 25 publications

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“…One of the most sensitive and specific imaging modalities for surveillance following treatment for OPSCC that has emerged is 18 F-fluorodeoxyglucose PET/CT. 8,9 Whereas PET/CT use after OPSCC has been investigated in recent studies, the current study is the first report limited to patients treated with a primary transoral robotic approach. In this particular population, these data demonstrate an excellent prognosis for a negative PET/CT performed between 2 and 7 months after completion of treatment.…”

Section: Discussionmentioning

confidence: 99%

Positron emission tomography/computed tomography after primary transoral robotic surgery for oropharyngeal squamous cell carcinoma

et al. 2017

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confidence: 99%

Positron emission tomography/computed tomography after primary transoral robotic surgery for oropharyngeal squamous cell carcinoma

et al. 2017

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“…As the presence of nodal metastasis is one of the most important prognostic factors for patients with HNSCC, accurate nodal staging of these patients is essential for both appropriate management and prognostic purposes [2, 7, 10]. …”

Section: Discussionmentioning

confidence: 99%

Utility of SUVmax on 18 F-FDG PET in detecting cervical nodal metastases

et al. 2016

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BackgroundThe presence of cervical lymph node metastasis is an important prognostic factor for patients with head and neck squamous cell carcinomas (HNSCC). Accurate assessment of lymph node metastasis in these patients is essential for appropriate prognostic and management purposes. Here, we evaluated the effectiveness of the maximum standardized uptake value (SUVmax) on positron emission tomography (PET) in assessing lymph node metastasis in HNSCC prior to surgery.MethodsA retrospective review of 74 patients with HNSCC who underwent PET/CT prior to neck dissection were examined. Pre-operative PET/CT scans were reviewed by two experienced nuclear medicine physicians and SUVmax of the largest node in each nodal basin documented. These were compared with the histology results of the neck dissection.ResultsA total of 359 nodal basins including 86 basins with metastatic nodes were evaluated. A nodal SUVmax ≥3.16 yielded a sensitivity of 74.4 % and specificity of 84.9 % in detecting metastatic nodes. The nodal SUVmax/Liver SUVmax ratio was found on receiver operating characteristic (ROC) to be effective in detecting metastatic nodes with an area under ROC curve of 0.90. A nodal SUVmax/Liver SUVmax ratio ≥0.90 yielded a sensitivity of 74.1 % and specificity of 93.4 %. By comparison, visual inspection yielded sensitivities of 66.3 and 61.6 % in observers 1 and 2 respectively. The corresponding specificities were 77.7 and 86.5 %.ConclusionsNodal SUVmax and nodal SUVmax/liver SUVmax are both useful in the pre-operative detection of metastatic nodes with the latter being superior to visual inspection. The ratio is likely to be more useful as it corrects for inter-scanner variability.

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“…Fixed nodes indicate disruption of fascial compartments and lymphatic flow pattern; therefore, an SND may result in incomplete elimination of disease. It is worth noting that imaging techniques, such as US, computed tomography (CT), magnetic resonance imaging and positron emission tomography are more extensively used than in the past and their accuracy has definitely improved [27]. Particularly, CT is routinely used for staging cervical nodes, but its ability in detecting enlarged nodes is different from that in discriminating metastatic nodes from reactive ones.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Therapeutic Selective Neck Dissection in Laryngeal Cancer

Allegra

Franco²,

Domanico³

et al. 2014

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Background: The aim of this study was to evaluate the effectiveness of selective neck dissection (SND) in patients with laryngeal cancer and clinically positive cervical nodes. Subjects and Methods: A retrospective review of the clinical records of 58 consecutive untreated patients affected by laryngeal carcinoma and submitted to surgical treatment was performed. Results: Twenty-six (44.8%) patients received monolateral neck dissection and 32 (55.2%) bilateral neck dissection. A total of 90 hemineck dissections were performed. Histopathological examination revealed that 25 of the 58 patients had negative nodes (pN0) and 33 had positive nodes (pN+). Extracapsular spread was found in 12 of the 33 pN+ patients. Twenty-eight of the 58 (48.2%) patients were submitted to adjuvant radiotherapy. Six of the 58 patients submitted to neck dissection had neck recurrence (rate of 10.3%). The only independent prognostic factor for neck recurrence was extracapsular spread. For the 58 patients, the 5-year overall survival was 50% and the disease-specific survival 68.9%. The 5-year disease-specific survival was 76% for pN0 patients and 63.6% for pN+ patients. Conclusions: SND can represent a therapeutic procedure because it has shown oncological results comparable to those of comprehensive neck dissection, especially when SND is combined with adjuvant radiotherapy.

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Effectiveness of PET/CT in the preoperative evaluation of neck disease

Cited by 27 publications

References 25 publications

Positron emission tomography/computed tomography after primary transoral robotic surgery for oropharyngeal squamous cell carcinoma

Positron emission tomography/computed tomography after primary transoral robotic surgery for oropharyngeal squamous cell carcinoma

Utility of SUVmax on 18 F-FDG PET in detecting cervical nodal metastases

Effectiveness of Therapeutic Selective Neck Dissection in Laryngeal Cancer

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