18F-FDG PET/CT versus CT/MR imaging for detection of neck lymph node metastasis in palpably node-negative oral cavity cancer.

Abstract

PURPOSE:

Subclinical lymph node (LN) metastasis is associated with poor survival outcome in oral cavity squamous cell carcinoma (OCC), which alleges elective neck LN dissection. Preoperative detection of metastatic LNs may improve prognosis and proper management of OCC. We examined the clinical usefulness of fluorine 18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) for the detection of occult neck LN metastasis in OCC patients in comparison with conventional CT/magnetic resonance (MR) imaging.

METHODS:

A total of 178 OCC patients with negative neck palpation findings were assessed prospectively with 18F-FDG PET/CT and CT/MR imaging. Histopathological analyses of neck dissection samples served as reference. Diagnostic values of 18F-FDG PET/CT versus CT/MR imaging were compared with the McNemar test and logistic regression with generalized estimating equations.

RESULTS:

Forty-two patients (23.6%) had metastasis in 44 sides and 58 levels of the neck. The sensitivity for detection of occult metastasis was higher for 18F-FDG PET/CT than that for CT/MR imaging on a per-patient (69.1% vs 35.7%), per-side (70.5% vs 36.4%), and per-level (62.1% vs 29.3%) basis (all P ≤ 0.001). However, the specificity for metastatic detection was higher for CT/MR imaging than that for 18F-FDG PET/CT (all P < 0.005). 18F-FDG PET/CT improved detection of occult metastasis up to 33.4% in these patients compared to CT/MR imaging.

CONCLUSIONS:

18F-FDG PET/CT can better detect occult neck metastasis than CT/MR imaging, which may potentially impact the clinical management of OCC patients.

• Authors: Mi Rye Bae, Jong-Lyel Roh, Jae Seung Kim, Jeong Hyun Lee, Kyung-Ja Cho, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 146 Issue 1 Pg. 237-244 (Jan 2020) ISSN: 1432-1335 [Electronic] Germany
• PMID: 31606761 (Publication Type: Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Fluorodeoxyglucose F18
• Humans
• Lymph Nodes (diagnostic imaging, pathology, surgery)
• Lymphatic Metastasis
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Mouth Neoplasms (diagnostic imaging, pathology, surgery)
• Positron Emission Tomography Computed Tomography (methods)
• Prospective Studies
• Radiopharmaceuticals
• Young Adult