The Prognostic and Diagnostic Value of [18F]FDG PET/CT in Untreated Laryngeal Carcinoma

Abstract

This study aims to determine the diagnostic accuracy of staging PET/CT and neck MRI in patients with laryngeal carcinoma and to assess the value of PET/CT in predicting progression-free survival (PFS) and overall survival (OS). Sixty-eight patients who had both modalities performed before treatment between 2014 and 2021 were included in this study. The sensitivity and specificity of PET/CT and MRI were evaluated. PET/CT had 93.8% sensitivity, 58.3% specificity, and 75% accuracy for nodal metastasis, whereas MRI had 68.8%, 61.1%, and 64.7% accuracy, respectively. At a median follow-up of 51 months, 23 patients had developed disease progression and 17 patients had died. Univariate-survival analysis revealed all utilized PET parameters as significant prognostic factors for OS and PFS (p-value < 0.03 each). In multivariate analysis, metabolic-tumor volume (MTV) and total lesion glycolysis (TLG) predicted better PFS (p-value < 0.05 each). In conclusion, PET/CT improves the accuracy of nodal staging in laryngeal carcinoma over neck MRI and adds to the prognostication of survival outcomes through the use of several PET metrics.

FDG PET/CT reveals bone marrow oligometastasis in laryngeal squamous carcinoma: a case report with favorable outcome

“…15 It outperforms MRI in detecting and assessing nodal and metastatic disease. 16 The overall sensitivity and specificity ranks above 90% in detecting metastases. 17 Therefore, utilizing 18 F-FDG PET/CT for a whole-body examination can provide a comprehensive assessment and identify any potential distant bone or bone marrow metastases, regardless of whether they are widespread or limited in number (oligometastatic).…”

The Prognostic Value of Sequential 18F-FDG PET/CT Metabolic Parameters in Outcomes of Upper-Third Esophageal Squamous Cell Carcinoma Patients Treated with Definitive Chemoradiotherapy

“…17,19,21,22,42 The prognostic value of these parameters for treatment outcome was approved in laryngeal carcinoma and nonsmall cell lung cancer in recent studies. 43,44 A systemic review of Cremonesi et al showed that there were not constant correlation between sequential 18 F-FDG PET/CT parameters and clinical outcomes among studies (►Table 4). 45 Therefore, further research is needed with uniform protocol and method of analysis to assess prognostic value of sequential 18 F-FDG PET/CT.…”

Comprehensive literature review of oral and intravenous contrast-enhanced PET/CT: a step forward?

“…Squamous cell carcinoma (SCC) represents the most common head and neck tumor type (95%). 18 F-FDG cePET/CT with dual phase has been proved superior to conventional imaging by MRI or CT for diagnosis and staging of patients with laryngeal carcinoma, with an higher rate of regional nodal, distant metastasis, and synchronous tumors ( 5 , 47 ). More globally, 18 F-FDG PET/CT is a recognized modality for the staging and follow-up of head and neck SCC ( 48 , 49 ).…”

“…Positron Emission Tomography (PET) is a molecular imaging technique that enhances diagnostic performance ( 2 ), therapeutic response monitoring ( 3 ), prognosis evaluation ( 4 , 5 ) and modifies the management of patients with hematological ( 6 ) or solid malignancy ( 7 ). However, it is sensitive to attenuation.…”