Radiat Oncol J.  2012 Dec;30(4):173-181.

Prognostic value of 18F-fluorodeoxyglucose positron emission tomography, computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with pathologically positive neck lymph node

• Jwa E
• Lee SW
• Kim JS
• Park JH
• Kim SS
• Kim YS
• Yoon SM
• Song SY
• Kim JH
• Choi EK
• Ahn SD

Abstract

PURPOSE
To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN.
MATERIALS AND METHODS
In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative 18F-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of 18F-FDG PET and CT/MRI.
RESULTS
Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by 18F-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by 18F-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value (SUVmax) on clinical outcomes. Notably, SUVmax showed significant correlation with tumor size in LN (p < 0.01, R2 = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p < 0.05, R2 = 0.37 and p < 0.01, R2 = 0.48, respectively).
CONCLUSION
18F-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of SUVmax.

Keyword

Oral cavity squamous cell carcinoma; Neck lymph node; Magnetic resonance imaging; X-ray computed tomography; 18F-FDG PET; Prognostic value

MeSH Terms

Carcinoma, Squamous Cell
Disease-Free Survival
Electrons
Fluorodeoxyglucose F18
Follow-Up Studies
Humans
Lymph Nodes
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Magnetics
Magnets
Mouth
Neck
Neck Dissection
Neoplasm Metastasis
Positron-Emission Tomography
Radiotherapy, Adjuvant
Retrospective Studies
Survival Rate
Tomography, X-Ray Computed
Fluorodeoxyglucose F18