Contribution of 18F-FDG PET/CT to Staging of Head and Neck Malignancies.

Yeşim Ceylan,Özgür Ömür,Filiz Hatipoğlu

doi:10.4274/mirt.51423

Abstract

Objective:Accurate staging of head and neck cancer (HNC) plays an important role in patient management as well as protection of functional characteristics of the head and neck region. Our aim was to investigate the contribution of 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron emission tomography/computed tomography (PET/CT) as part of HNC staging to clinical evaluation and treatment planning.Methods:Clinical records of 138 HNC cases who has undergone 18F-FDG PET/CT imaging were retrospectively reviewed. Sixty-five cases who had accessible clinical follow-up data were included in the study group, and their PET/CT and conventional imaging findings were evaluated.Results:In the case group with a PET/CT and magnetic resonance imaging (MRI) for evaluation of primary lesion the sensitivity rates for PET/CT and MRI were calculated as 91.3% and 82.6%, the positive predictive values (PPV) as 91.3% and 82.6%, specificity as 71.4% and 42.8%, and the negative predictive value (NPV) as 71.4% and 42.8%, respectively. In terms of metastatic lymph node evaluation, the sensitivity was calculated as 100% and 88.8%, the NPV as 100% and 83.3%, respectively. The PPV and specificity was 100% for both modalities. In the case group with CT for primary lesion evaluation, the sensitivity and PPV were found as 95.2% and 100% for PET/CT, and as 85.7% and 94.7% for CT, respectively. in metastatic lymph node evaluation, the sensitivity was found as 100% for PET/CT and 50% for CT, and the PPV, specificity and NPV were determined as 100% for both methods. PET/CT findings resulted in a change in ‘tumor, node, metastasis’ staging in 5 cases.Conclusion:PET/CT in HNC contributes to staging, thus playing a role in treatment planning, especially in patients with locally advanced disease.

Highlights

Thorough evaluation of patients with head and neck cancer (HNC), which include malignancies originating from the paranasal sinus, nasal-oral cavity, pharynx and larynx, is fundamental in order to apply the most appropriate treatment while optimizing functional and cosmetic outcomes
It was aimed to investigate the contribution of 18F-FDG positron emission tomography/computed tomography (PET/computed tomography (CT)) imaging method as part of HNC staging to clinical evaluation and treatment planning
Our study group consisted of 65 patients who has undergone whole-body positron emission tomography (PET)/CT imaging and whose follow-up data were accessible. 18F-FDG PET/CT imaging was performed for staging in 37 cases and re-staging in 28 cases

Summary

Introduction

Thorough evaluation of patients with head and neck cancer (HNC), which include malignancies originating from the paranasal sinus, nasal-oral cavity, pharynx and larynx, is fundamental in order to apply the most appropriate treatment while optimizing functional and cosmetic outcomes. Ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) are used prior to selecting treatment modality as well as endoscopic evaluation. CT is especially useful in the evaluation of lung metastasis and local or metastatic bone involvement. It is generally insufficient in determining cartilage invasions and in differentiating tissue thickening from tissue damage caused by the tumor [1]. MRI is superior to CT in terms of local evaluation of the primary tumor by showing bone marrow involvement [2]. 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography (PET)/CT, which provides both metabolic and anatomical information and simultaneously evaluates local tumor and distant metastases, is required for accurate staging [4]

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