Prospective comparison of 18 F-FDG PET with conventional imaging modalities (CT, MRI, US) in lymph node staging of head and neck cancer

Adams, Stefan; Baüm, Richard; Stuckensen, Tankred; Bitter, Kerstin; Hör, G.

doi:10.1007/s002590050293

Cited by 453 publications

(273 citation statements)

References 22 publications

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“…In only one of our cases, FDG-PET was performed, showing a preclinical lung inflammatory process diagnosed as pneumocystosis. In a recent study, FDG-PET scan did not detect occult tumors not detected by conventional CT/MR imaging (31).…”

Section: Discussionmentioning

confidence: 84%

“…For ACTH-dependent differential diagnosis, patients underwent HDDST (8 mg) (14)(15)(16), desmopressin test (17,18), corticotropin-releasing hormone (CRH) test (19)(20)(21)(22)(23), growth hormone releasing peptide (GHRP)-6 test (24,25), and IPSS (26)(27)(28) with desmopressin stimulus indicated when magnetic resonance imaging (MRI) was negative for a pituitary lesion. IPSS was performed by collecting blood samples simultaneously from the inferior petrosal sinuses and a peripheral vein before and 3, 5, and 10 min after 10 mg of IV desmopressin (DDAVP, Ferring Pharmaceuticals, Limhamn, Sweden) (29 (31)(32)(33). Tumor markers, such as calcitonin, gastrin, carcinoembryonic antigen (CEA), a-fetoprotein, b human chorionic gonadotropin (bHCG), and 5-hydroxyindolacetic acid (5-HIAA), were also measured.…”

Section: Diagnosis Of Ectopic Acth Syndromementioning

confidence: 99%

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Ectopic ACTH syndrome: our experience with 25 cases

Fragoso²,

et al. 2006

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Objective: Ectopic ACTH syndrome (EAS) occurs in about 5-10% of all patients with ACTH-dependent hypercortisolism with most of them caused by intrathoracic neoplasms. It may be associated with overt malignancies or with occult and indolent tumors. We assessed the accuracy of dynamic tests, inferior petrosal sinus sampling (IPSS) using desmopressin, and imaging in the work-up diagnosis of EAS. Design and subjects: Tumor markers, imaging, and outcome data from 25 patients (13F/12M) aged 18-72 years. High dexamethasone suppression test (HDDST), desmopressin test, GHRP-6 test, corticotropin-releasing hormone (CRH) test, IPSS, computed tomography (CT), magnetic resonance imaging (MRI), and 111 In-pentetreotide scintigraphy were revised. Results: In 5 out of 20 patients HDDST was positive. In 13 patients who underwent desmopressin test, ACTH-and cortisol-positive responses were seen in six and five patients respectively. GHRP-6 test was positive in two out of three cases. Two patients underwent CRH test with negative response. In the seven patients submitted to IPSS using desmopressin in six of them, none had ACTH gradients. CT was positive in 15 out of 21 patients and MRI in 8 out of 17 cases.111 In-pentetreotide scintigraphy was positive in three out of five patients. Fourteen patients had intrathoracic tumors, five had pheochromocytomas, three had pancreatic tumors, one had a glomic tumor, and had three occult tumors. Six out of 11 patients with metastasis died and 3 others without metastasis died. Conclusions: IPSS with desmopressin was helpful for differential diagnosis. Patients initially harboring occult carcinoids may also exhibit severe hypercortisolism and those harboring tymic carcinoids had poor prognoses when compared with bronchial carcinoids and pheocromocytomas.European Journal of Endocrinology 155 725-733

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Section: Discussionmentioning

confidence: 84%

Section: Diagnosis Of Ectopic Acth Syndromementioning

confidence: 99%

Ectopic ACTH syndrome: our experience with 25 cases

Fragoso²,

et al. 2006

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“…PET has been shown to be superior to conventional imaging modalities for the detection of regional nodal metastases [18]. The increased glucose metabolism can be identified in lymph nodes infiltrated by tumor cells regardless of size criteria.…”

Section: N Stagementioning

confidence: 99%

Indications for PET/CT in the Head and Neck

Agarwal

Branstetter

Johnson

2008

Otolaryngologic Clinics of North America

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Head and neck cancer accounts for approximately 3% to 5% of all new cancer diagnoses in the United States with 40,000 new cases diagnosed each year [1]. These figures encompass cancers arising from the lip, oral cavity, nasal cavity, paranasal sinuses, pharynx, and larynx, of which the vast majority (90% to 95%) are squamous cell carcinomas arising from mucosal linings of the upper aerodigestive tract. Other, rare cancers that may involve the head and neck include salivary tumors, thyroid cancers, lymphoma, and melanoma.Early diagnosis and accurate staging are essential for treatment planning and can strongly influence prognosis. Likewise, early identification of tumor recurrence can often be treated with additional surgery or re-irradiation. A combination of history, physical exam, endoscopy, and tissue sampling has historically been the mainstay of diagnosis and staging. The use of crosssectional imaging (CT and MRI) has greatly improved staging and monitoring for disease recurrence. Small metastases and/or early recurrent disease, however, can still be missed [2].Functional imaging with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) can be used to fill these gaps and improve characterization of both primary tumors and metastatic disease. PET has been shown to be effective in the diagnosis of many different types of cancer, including head and neck squamous cell carcinoma (HNSCC) [3]; however, the poor spatial resolution of PET and the lack of anatomic landmarks can make exact localization of disease difficult. In addition, normal

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“…Several authors have reported the use of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) scanning in cancer of the head and neck, both in the setting of primary staging 4 and the evaluation of patients after primary therapy. 5 -7 The promising results of these studies and the clear need for better evaluation of patients with head and neck cancer after attempted curative therapy encouraged us to evaluate the use of PET scanning in our institution in the setting of a tertiary referral center for management of head and neck cancer.…”

mentioning

confidence: 99%

Usefulness of fluorine‐18 fluorodeoxyglucose positron emission tomography in patients with a residual structural abnormality after definitive treatment for squamous cell carcinoma of the head and neck

et al. 2004

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Background. Residual structural abnormalities after definitive treatment of head and neck squamous cell carcinoma (HNSCC) are common and pose difficult management problems. The usefulness of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) to supplement conventional evaluation with clinical and standard radiologic examination (CE) in such patients was assessed.Methods. Fifty-three eligible patients were identified with residual structural abnormalities on CE. True disease extent could be validated in 46 patients. Patients had a median potential follow-up of 55 months (range, 41 -75 months) from the date of PET scan to the analysis closeout date.Results. PET had better diagnostic accuracy than CE (p = .0002) and induced management change in 21 patients (40%; 95% confidence interval [CI], 26% -54%), including avoidance of unnecessary planned surgery in 14 patients with negative PET. Appropriate management change was confirmed in 19 (95%) of 20 evaluable cases. Disease presence and extent assessment by PET were significant predictors of survival (p < .0001), whereas the extent of disease determined by CE was not.Conclusion. PET added significantly to the value of CE in restaging disease in patients with structural abnormalities after definitive treatment of HNSCC. Management decisions based on PET were appropriate in most patients. A

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Prospective comparison of 18 F-FDG PET with conventional imaging modalities (CT, MRI, US) in lymph node staging of head and neck cancer

Cited by 453 publications

References 22 publications

Ectopic ACTH syndrome: our experience with 25 cases

Ectopic ACTH syndrome: our experience with 25 cases

Indications for PET/CT in the Head and Neck

Usefulness of fluorine‐18 fluorodeoxyglucose positron emission tomography in patients with a residual structural abnormality after definitive treatment for squamous cell carcinoma of the head and neck

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