FDG PET in oral and oropharyngeal cancer. Value for confirmation of N0 neck and detection of occult metastases

Abstract

FDG PET in oral and oropharyngeal cancer. Value for confirmation of N0 neck and detection of occult metastases Krabbe, Christiaan A.; Dijkstra, Pieter U. ; Pruim, Jan; van der Laan, Bernard F.A.M.; van der Wal, Jacqueline E.; Gravendeel, Joost P.; Roodenburg, Johannes Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Summary Treatment of the clinical N0 neck in squamous cell carcinoma (SCC) of oral cavity and oropharynx remains a dilemma. None of the current imaging modalities are able to detect the presence of micrometastases in the lymph nodes of clinical N0 necks reliably. The aim of this study was to determine the diagnostic properties of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) in patients clinically staged as N0. FDG PET results of 38 patients were compared to histologic specimens obtained with neck dissections or to follow-up. FDG PET performance was compared to computed tomography (CT), magnetic resonance imaging (MRI) or ultrasonography-guided fine needle aspiration cytology (USgFNAC). Sensitivity and specificity of FDG PET in detecting occult cervical metastases were 50% and 97% respectively. Although FDG PET performed better than conventional imaging modalities, sensitivity was lower than desired. As a consequence, clinical application of FDG PET in the patient staged as N0 is limited.

Evaluation of knowledge, attitude, and practice regarding positron emission tomography scan: A cross-sectional survey

“…The subjects in our study strongly agreed that PET scan can determine the extent of their location and number of metastasis. This is in accordance with the results obtained by Krabbe et al 19 The respondents strongly agreed with the concept of advising PET scan in pregnant women as the fetal radiation dose from 18 F-FDG PET is quite low and significantly below the threshold dose for deterministic effects. Although F-FDG is believed to cross the placental membrane and accumulate in the fetus, there are no scientific studies documenting the fetal toxicity associated with it.…”

Clinical Significance of Combined Assessment of the Maximum Standardized Uptake Value of F-18 FDG PET with Nodal Size in the Diagnosis of Cervical Lymph Node Metastasis of Oral Squamous Cell Carcinoma

“…Several previous studies have compared diagnostic accuracy in the evaluation of cervical nodal metastasis in head and neck SCC between different imaging modalities including CT, MRI, US, and F-18 FDG PET (17,18,20,21,23,25,27,(30)(31)(32)(33)(34)(50)(51)(52). Adams et al compared F-18 FDG PET with conventional imaging modalities (CT, MRI, and US) in the lymph node staging of 60 patients with head and neck SCC.…”

Performance of 18F-FDG PET/contrast-enhanced CT in the staging of squamous cell carcinoma of the oral cavity and oropharynx

“…Stand alone 18 F-FDG PET is either complementary to, or shows a better performance in detecting cervical metastases than, CT or MRI 2,21,22 . The accuracy of 18 F-FDG PET in detecting cervical metastases, is not optimal as small cervical metastases can be missed, especially concerning the clinically N0 neck 6,13,16,32 . Although several studies showed that PET/CT is more accurate in staging than CT, PET or MRI alone 8,9,16,31 , data available on the value of PET/CT in detecting cervical metastases are scarce ( Table 7).…”