Korean J Otorhinolaryngol-Head Neck Surg.  2010 Jul;53(7):419-424. 10.3342/kjorl-hns.2010.53.7.419.

Role of Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography in Preoperative Staging of Early Glottic Cancer

• Song CI
• Han MW
• Lee YS
• Kim SY
• Choi SH
• Nam SY

• KMID: 2037228
• DOI: http://doi.org/10.3342/kjorl-hns.2010.53.7.419

Abstract

BACKGROUND AND OBJECTIVES
Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) has been widely used to detect regional and distant metastasis or second primary cancers at initial evaluation. The aim of this study was to evaluate the role of combined FDG-PET/CT in detecting early glottic cancers, which has low incidence of regional or distant metastasis.
SUBJECTS AND METHOD
We enrolled in our study 551 patients who had previously untreated glottic cancer between 2001 and 2008. Of these, 124 patients with early glottic cancer underwent FDG-PET/CT. Retrospectively, we compared the detection rates of regional, distant metastasis or second primary cancer by FDG-PET/CT with those after neck computed tomography (CT), chest X-ray, and liver sonography.
RESULTS
In detecting regional metastasis, the sensitivity and specificity of FDG-PET/CT were 66.67% and 97.25%, respectively, with the positive predictive value (PPV) of 40%, the negative predictive value (NPV) of 99.16%, and the accuracy of 96.77%. The sensitivity, specificity, PPV, NPV and accuracy of neck CT were 66.67%, 96.69%, 33.33%, 99.15%, and 95.96%, respectively. The suspicious distant metastasis (n=1) and second primary cancers (n=7) were observed in FDG-PET/CT. The true second primary cancers occurred at the colon (n=1) and the prostate (n=2). The other cases were proved to be false positive. Distant metastasis and second primary cancers were not detected by the conventional work-up tests.
CONCLUSION
The regional metastasis detection rate of FDG-PET/CT was similar to those of the conventional work-up tests. However, compared to the conventional tests, FDG-PET/CT is useful for detecting distant metastasis or second primary cancers in patients with early glottic cancer.

Keyword

Positron-emission tomography/computed tomography; Larynx cancer; Neoplasm metastasis; Second primary neoplasm

MeSH Terms

Colon
Humans
Incidence
Laryngeal Neoplasms
Liver
Neck
Neoplasm Metastasis
Neoplasms, Second Primary
Prostate
Retrospective Studies
Sensitivity and Specificity
Thorax