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

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.

Download Full-text

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

Toukeibu Gan ◽

10.5981/jjhnc.35.400 ◽

2009 ◽

Vol 35 (4) ◽

pp. 400-405 ◽

Cited By ~ 1

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

Download Full-text

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

Nuklearmedizin ◽

10.1055/s-0038-1632228 ◽

1999 ◽

Vol 38 (08) ◽

pp. 312-318 ◽

Cited By ~ 54

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.

Download Full-text