FDG PET/MR for lymph node staging in head and neck cancer

2014 ◽  
Vol 83 (7) ◽  
pp. 1163-1168 ◽  
Author(s):  
Ivan Platzek ◽  
Bettina Beuthien-Baumann ◽  
Matthias Schneider ◽  
Volker Gudziol ◽  
Hagen H. Kitzler ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Node ◽  
Head And Neck ◽  
Neck Cancer ◽  
Fdg Pet ◽  
Lymph Node Staging

Lymph node staging in extracranial head and neck cancer with FDG PET – appropriate uptake period and size-dependence of the results

2002 ◽  
Vol 41 (02) ◽  
pp. 108-113 ◽  
Author(s):  
Th. Klenzner ◽  
Th. Krause ◽  
M. Mix ◽  
U. H. Ross ◽  
E. Moser ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Neck Cancer ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Lymph Node Staging ◽  
Cellular Activity ◽  
Plateau Phase

Summary Aim: Identification of a rationale for the appropriate uptake period for static clinical extracranial head and neck PET imaging and evaluation of the diagnostic accuracy of such an optimized FDG PET approach for lymph node staging in the head and neck region. Methods: In a subset of 5 patients, kinetic tumour studies were performed in order to identify the cellular activity plateau phase of FDG accumulation for head and neck cancer. Seventy-eight consecutive patients (11 women, 67 men; mean age ± SD: 55 ± 11 years; range, 36-78 years), presenting with histologically proven squamous cell carcinoma and sonographically detected lymph nodes in 86 neck sides, underwent clinically indicated FDG PET imaging. PET results were compared to those derived from histological examinations and follow-up imaging results after 6 months in order to calculate sensitivity and specificity for lymph node staging. Results: FDG kinetics in head and neck cancer indicate that the cellular activity plateau of FDG accumulation is reached after an uptake period of 90 min. Using this protocol metastatic involvement of neck sides with lymph nodes less than 1 cm in diameter was correctly identified with a sensitivity of 71.4% and a specificity of 92.3%. Sensitivity increased with the lymph node diameter (1.1-1.5 cm 83.3%, 1.6-2.0 cm 100%, > 2 cm 88.9%). Conclusion: The appropriate uptake period for static clinical extracranial head and neck PET imaging that allows measurements in the activity plateau phase is about 90 min. FDG PET may add some significant information regarding metastatic spread into regional lymph nodes.

scholarly journals FDG-PET staging and importance of lymph node SUV in head and neck cancer

2010 ◽  
Vol 2 (1) ◽  
Author(s):  
Gregory J Kubicek ◽  
Collin Champ ◽  
Shannon Fogh ◽  
Fen Wang ◽  
Eashwer Reddy ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Node ◽  
Head And Neck ◽  
Neck Cancer ◽  
Fdg Pet

scholarly journals A clinical study of a comparison between ultrasonography and FDG-PET for detection of lymph node metastases in head and neck cancer

Toukeibu Gan ◽  
2009 ◽  
Vol 35 (4) ◽  
pp. 400-405 ◽  
Author(s):  
Ibuki Hayashi ◽  
Terue Okamura ◽  
Yoshitsugu Nimura ◽  
Kengo Ichihara ◽  
Yuuichirou Tsuji ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Node ◽  
Clinical Study ◽  
Head And Neck ◽  
Neck Cancer ◽  
Lymph Node Metastases ◽  
Fdg Pet ◽  
Node Metastases

scholarly journals Clinical Applications of FDG PET and PET/CT in Head and Neck Cancer

2009 ◽  
Vol 2009 ◽  
pp. 1-13 ◽  
Author(s):  
Akram Al-Ibraheem ◽  
Andreas Buck ◽  
Bernd Joachim Krause ◽  
Klemens Scheidhauer ◽  
Markus Schwaiger
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Fdg Pet ◽  
Radiation Treatment ◽  
Clinical Applications ◽  
Lymph Node Staging ◽  
Complex Anatomy ◽  
Pet Ct ◽  
18F Fdg

18F-FDG PET plays an increasing role in diagnosis and management planning of head and neck cancer. Hybrid PET/CT has promoted the field of molecular imaging in head and neck cancer. This modality is particular relevant in the head and neck region, given the complex anatomy and variable physiologic FDG uptake patterns. The vast majority of 18F-FDG PET and PET/CT applications in head and neck cancer related to head and neck squamous cell carcinoma. Clinical applications of 18F-FDG PET and PET/CT in head and neck cancer include diagnosis of distant metastases, identification of synchronous 2nd primaries, detection of carcinoma of unknown primary and detection of residual or recurrent disease. Emerging applications are precise delineation of the tumor volume for radiation treatment planning, monitoring treatment, and providing prognostic information. The clinical role of 18F-FDG PET/CT in N0 disease is limited which is in line with findings of other imaging modalities. MRI is usually used for T staging with an intense discussion concerning the preferable imaging modality for regional lymph node staging as PET/CT, MRI, and multi-slice spiral CT are all improving rapidly. Is this review, we summarize recent literature on 18F-FDG PET and PET/CT imaging of head and neck cancer.

Combined image interpretation of computed tomography and hybrid PET in head and neck cancer

2002 ◽  
Vol 41 (01) ◽  
pp. 14-21 ◽  
Author(s):  
J. E. Wildberger ◽  
U. Cremerius ◽  
E. DiMartino ◽  
S. Jaenicke ◽  
B. Nowak ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Head And Neck Cancer ◽  
Lymph Node ◽  
Head And Neck ◽  
Neck Cancer ◽  
Image Interpretation ◽  
Lymph Node Staging ◽  
Sensitivity Specificity ◽  
Recurrent Head ◽  
Dedicated Pet

Summary Aim: Evaluation of potential synergistic effects of combined image interpretation of FDG PET using a gamma camera modified for coincidence detection (hybrid PET) and computed tomography (CT) and comparison of the diagnostic accuracy of hybrid PET and dedicated PET in patients with head and neck cancer. Methods: Forty-two patients with suspected primary or recurrent cancer were included. Twenty-four patients underwent dedicated PET in addition to attenuationcorrected hybrid PET using a one-day protocol. Results: Sensitivity, specificity and accuracy for detection of primary or recurrent head and neck cancer were 74, 73, and 74% for hybrid PET, 52, 82, and 60% for CT and 77, 82, and 79% for combined reading. With the combination of CT and hybrid PET all cases of recurrent disease were detected. The largest tumour not detected was 1.7 cm in diameter. Sensitivity, specificity and accuracy for the detection of neck sides with lymph node metastases were 69, 88, and 85% for hybrid PET, 62, 88, and 84% for CT, 69, 99, and 94% for combined image interpretation. With combined interpretation four involved neck sides were missed including two cases of microscopic metastases. Hybrid PET revealed concordant results to dedicated PET in all patients with respect to the detection of primary or recurrent tumour and in 45 of 48 neck sides (94%) with the same number of false negative findings. Conclusion: The combination of functional information of hybrid PET and morphological information of CT by the simple approach of combined image interpretation improves the sensitivity for the detection of primary/recurrent head and neck cancer and increases the specificity of lymph node staging compared to CT alone. The accuracy of hybrid PET and dedicated PET was almost identical.

Diagnostic Evaluation of Malignant Head and Neck Cancer by F-18-FDG PET Compared to CT/MRI

1999 ◽  
Vol 38 (08) ◽  
pp. 312-318 ◽  
Author(s):  
E. Di Martino ◽  
S. Jänicke ◽  
U. Cremerius ◽  
G. Adam ◽  
M. Zimny ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Node ◽  
Diagnostic Accuracy ◽  
Head And Neck ◽  
Glucose Uptake ◽  
Neck Cancer ◽  
Lymph Node Metastases ◽  
Fdg Pet ◽  
Lower Glucose ◽  
Node Metastases

Summary Aim: Evaluation of F-18-FDG PET in comparison to CT/MRI as diagnostic tool in primary and recurrent head and neck cancer. Methods: 78 F-18-FDG PET studies were performed in 71 patients with known or suspected primary (n=48) or recurrent (n=30) head and neck cancer and compared to CT (n=75) or MRI investigations (n=3) concerning detection of the primary or recurrent tumor and detection of regional lymph node metastases in the ipsilateral and contralateral neck sides. Glucose uptake (SUV) of PET findings was correlated to tumor location, grading and dignity of the lesion. Results: Sensitivity and specificity for PET in detection of primary tumors were 87%* and 67%, respectively (CT/MRI 67%* and 44%) (*p<0.05), in detection of local recurrence 86% and 75%, respectively (CT/MRI 57% and 92%), in detection of necks affected by lymph node metastases 80% and 92%, respectively (CT/MRI 80% and 84%). Laryngeal, buccal (cheek) and salivary gland tumors had significant lower glucose uptake (SUV) when compared to tumors of the hypopharynx (p<0.05). G1-tumors (mean SUV 4.26) had significant (p<0.05) lower glucose uptake when compared to G2- and G3-tumors (mean SUV 7.73 and 8.19, respectively). Mean SUV of malignant PET findings (7.88) was significant (p<0.05) higher than mean SUV of benign PET findings (5.70). However, a SUV threshold to improve diagnostic accuracy could not be defined. Conclusion: F-18-FDG PET is significantly more accurate than CT/MRI for detection of head and neck cancer. Both methods are valuable for detection of cervical lymph node metastases. Glucose uptake shows correlation to histological grading. A quantitative SUV analysis does not improve diagnostic accuracy.

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