Contrast-enhanced 18F-FDG-PET/CT for the assessment of necrotic lymph node metastases
✍ Scribed by Stephan K. Haerle; Klaus Strobel; Nader Ahmad; Alex Soltermann; Daniel T. Schmid; Sandro J. Stoeckli
- Publisher
- John Wiley and Sons
- Year
- 2010
- Tongue
- English
- Weight
- 368 KB
- Volume
- 33
- Category
- Article
- ISSN
- 1043-3074
No coin nor oath required. For personal study only.
✦ Synopsis
Abstract
Background.
Cystic lymph node metastasis (CLNM) is commonly found in human papillomavirus (HPV)‐associated tonsillar squamous cell carcinoma (SCC). The aim of this study was to compare the accuracy in detecting cystic lymph node metastasis from tonsillar SCC between contrast‐enhanced CT, ^18^F‐ fluorodeoxyglucose‐positron emission tomography (FDG‐PET), non‐enhanced ^18^F‐FDG‐PET/CT, and contrast‐enhanced ^18^F‐FDG‐PET/CT.
Methods.
Thirty‐four patients with a tonsillar SCC undergoing a pretreatment contrast‐enhanced ^18^F‐FDG‐PET/CT followed by a neck dissection as a standard of reference were included. The contrast‐enhanced CT part, the ^18^F‐FDG‐PET part, the non‐enhanced ^18^F‐FDG‐PET/CT part, and the contrast‐enhanced ^18^F‐FDG‐PET/CT were assessed separately for correct N classification and the differentiation of N0 versus N+.
Results.
Contrast‐enhanced ^18^F‐FDG‐PET/CT, non‐enhanced ^18^F‐FDG‐PET/CT, and contrast‐enhanced CT are equally accurate for correct neck staging. Regarding pN0 versus pN+, contrast‐enhanced CT and contrast‐enhanced ^18^F‐FDG‐PET/CT are superior to non‐enhanced ^18^F‐FDG‐PET/CT (p = .017).
Conclusion.
Contrast‐enhanced CT and contrast‐enhanced ^18^F‐FDG‐PET/CT perform equally and better than non‐enhanced ^18^F‐FDG‐PET/CT in detecting CLNM in tonsillar SCC. Therefore, in patients scheduled for ^18^F‐FDG‐PET/CT, we strongly suggest performing a contrast‐enhanced ^18^F‐FDG‐PET/CT, which is not routine in most centers. © 2010 Wiley Periodicals, Inc. Head Neck, 2010