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

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 determi...

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Bibliographic Details
Published in:Oral oncology 2008-01, Vol.44 (1), p.31-36
Main Authors: Krabbe, Christiaan A, Dijkstra, Pieter U, Pruim, Jan, van der Laan, Bernard F.M, van der Wal, Jacqueline E, Gravendeel, Joost P, Roodenburg, Jan L.N
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Squamous Cell - diagnostic imaging
Carcinoma, Squamous Cell - secondary
Female
Fluorodeoxyglucose F18
Hematology, Oncology and Palliative Medicine
Humans
Lymph node metastases
Lymph Nodes - diagnostic imaging
Lymphatic Metastasis - diagnostic imaging
Male
Middle Aged
Mouth Neoplasms - diagnostic imaging
N0 neck
Oral and oropharyngeal cancer
Oropharyngeal Neoplasms - diagnostic imaging
Otolaryngology
Positron emission tomography
Positron-Emission Tomography - methods
Predictive Value of Tests
Radiopharmaceuticals
Sensitivity and Specificity
Squamous cell carcinoma
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Summary: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.
ISSN:1368-8375
1879-0593
DOI:10.1016/j.oraloncology.2006.12.003