Nucl Med Mol Imaging.  2006 Feb;40(1):23-27.

Hypermetabolism of Compensatory Laryngeal Muscles in Unilateral Vocal Cord Palsy: Comparison Study between Speech and Silence with Normal Subjects by Co-registered PET-CT Fusion Images

Affiliations
  • 1Department of Radiology, Ewha Womans University College of Medicine, Seoul, Korea. moonsunb@ewha.ac.kr
  • 2Department of Otolaryngology, Ewha Womans University College of Medicine, Seoul, Korea.

Abstract

PURPOSE: There are a few case reports on asymmetric vocal cord uptake on FDG-PET in patients with unilateral vocal cord paralysis, which could be a potential pitfall in the interpretation of FDG-PET images. We evaluated the metabolic activity of laryngeal muscles of patients with unilateral vocal cord paralysis in comparison to normal controls during both speech and silence.
METHODS
Eleven patients with unilateral vocal cord palsy (thyroidectomy=7, lung cancer=1, others=3) and 12 normal controls underwent FDG-PET with usual protocol. They were divided into two groups respectively; one group read books aloud for 20 minutes (phonation group) and the other kept silence (non-phonation groups) after FDG injection. Recent neck CT scan were co-registered with FDG-PET to produce PET-CT fusion images to elaborate small laryngeal muscles.
RESULTS
In patients with unilateral vocal cord palsy, contralateral non-paralyzed vocal cord showed hypermetabolism mainly on thyroarytenoid muscle, more intensely with phonation group (SUV=5.88+/-2.65) than with non-phonation group (SUV=2.30+/-0.39). Normal control subjects showed hypermetabolism (3.68+/-0.96) in interarytenoid muscle and symmetric mild hypermetabolism in both lateral cricoarytenoid muscles in only phonation group.
CONCLUSION
FDG-PET with fusion images using CT scan in patients with unilateral vocal cord paralysis showed hypermetabolism of contralateral non-paralyzed thyroarytenoid muscle, suggesting compensatory action during phonation. Phonation during FDG-PET study enhanced FDG uptake on different laryngeal muscles between patients with unilateral vocal cord paralysis and normal subjects.

Keyword

vocal cord palsy; 18F-FDG; fusion PET-CT

MeSH Terms

Fluorodeoxyglucose F18
Humans
Laryngeal Muscles*
Lung
Neck
Phonation
Tomography, X-Ray Computed
Vocal Cord Paralysis*
Vocal Cords*
Fluorodeoxyglucose F18
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