Nucl Med Mol Imaging.  2006 Dec;40(6):309-315.

Accuracy of F-18 FDG PET/CT in Preoperative Assessment of Cervical Lymph Nodes in Head and Neck Squamous Cell Cancer: Comparison with CT/MRI

• Choi SJ
• Byun SS
• Park SW
• Kim YM
• Hyun IY

Abstract

PURPOSE: Accurate evaluation of cervical lymph node (LN) metastasis of head and neck squamous cell cancer (SCC) is important to treatment planning. We evaluated the diagnostic accuracy of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of cervical LN metastasis of head and neck SCC and performed a retrospective comparison with CT/MRI findings.
MATERIALS AND METHODS
Seventeen patients with pathologically proven head and neck SCC underwent F-18 FDG PET/CT and CT/MRI within 4 week before surgery. We recorded lymph node metastases according to the neck level system of imaging-based nodal classification. F-18 FDG PET/CT images were analyzed visually for assessment of regional tracer uptake in LN. We analyzed the differences in sensitivity and specificity between F-18 FDG PET/CT and CT/MRI using the Chi-square test.
RESULTS
Among the 17 patients, a total of 123 LN levels were dissected, 29 of which showed metastatic involvement. The sensitivity and specificity of F-18 FDG PET/CT for detecting cervical LN metastasis on a level-by-level basis were 69% (20/29) and 99% (93/94). The sensitivity and specificity of CT/MRI were 62% (18/29) and 96% (90/94). There was no significant difference in diagnostic accuracy between F-18 FDG PET/CT and CT/MRI. Interestingly, F-18 FDG PET/CT detected double primary tumor (hepatocellular carcinoma) and rib metastasis, respectively.
CONCLUSION
There was not statistically significant difference of diagnostic accuracy between F-18 FDG PET/CT and CT/MRI for the detection of cervical LN metastasis of head and neck SCC. The low sensitivity of F-18 FDG PET/CT was due to limited resolution for small metastatic deposits.

Keyword

head and neck neoplasms; F-18 fluorodeoxyglucose; positron emission tomography; lymph nodes; neck; neoplasm metastasis

MeSH Terms

Classification
Electrons
Head and Neck Neoplasms
Head*
Humans
Lymph Nodes*
Neck*
Neoplasm Metastasis
Neoplasms, Squamous Cell*
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography*
Retrospective Studies
Ribs
Sensitivity and Specificity