BACKGROUND: 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been reported to be superior to computed tomography (CT)/magnetic resonance imaging (MRI) in the evaluation of head and neck cancers, but little is known about its usefulness in oropharyngeal squamous cell carcinoma (SCC). We therefore compared FDG PET and CT/MRI in the preoperative staging of previously untreated oropharyngeal SCC. METHODS: Thirty-two consecutive patients with oropharyngeal SCC underwent FDG PET and CT/MRI before surgery. Each method was interpreted separately to assess primary tumor and cervical node status. Their sensitivity and specificity were compared relative to histopathologic analysis. RESULTS: Histopathology revealed metastases in 29 of 39 dissected neck sides and in 47 of 163 dissected cervical levels. FDG PET had higher sensitivities than CT/MRI for primary tumor detection (25/32 vs. 30/32, P=0.063) and for identification of cervical metastases on neck side (22/29 vs. 28/29, P<0.05) and level-by-level (37/47 vs. 45/47, P<0.05) bases. In contrast, the specificity of the two methods did not differ significantly (P>0.5). FDG PET correctly interpreted the false-negative results of CT/MRI in 6 of 7 primary tumors and 8 of 10 cervical levels. CONCLUSIONS: The improved preoperative staging of FDG PET may help in planning treatment, but its accuracy is insufficient to replace pathologic staging based on neck dissection.
BACKGROUND:18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been reported to be superior to computed tomography (CT)/magnetic resonance imaging (MRI) in the evaluation of head and neck cancers, but little is known about its usefulness in oropharyngeal squamous cell carcinoma (SCC). We therefore compared FDG PET and CT/MRI in the preoperative staging of previously untreated oropharyngeal SCC. METHODS: Thirty-two consecutive patients with oropharyngeal SCC underwent FDG PET and CT/MRI before surgery. Each method was interpreted separately to assess primary tumor and cervical node status. Their sensitivity and specificity were compared relative to histopathologic analysis. RESULTS: Histopathology revealed metastases in 29 of 39 dissected neck sides and in 47 of 163 dissected cervical levels. FDG PET had higher sensitivities than CT/MRI for primary tumor detection (25/32 vs. 30/32, P=0.063) and for identification of cervical metastases on neck side (22/29 vs. 28/29, P<0.05) and level-by-level (37/47 vs. 45/47, P<0.05) bases. In contrast, the specificity of the two methods did not differ significantly (P>0.5). FDG PET correctly interpreted the false-negative results of CT/MRI in 6 of 7 primary tumors and 8 of 10 cervical levels. CONCLUSIONS: The improved preoperative staging of FDG PET may help in planning treatment, but its accuracy is insufficient to replace pathologic staging based on neck dissection.
Authors: Jon Cacicedo; Arturo Navarro; Olga Del Hoyo; Alfonso Gomez-Iturriaga; Filippo Alongi; Jose A Medina; Olgun Elicin; Andrea Skanjeti; Francesco Giammarile; Pedro Bilbao; Francisco Casquero; Berardino de Bari; Alan Dal Pra Journal: Br J Radiol Date: 2016-08-02 Impact factor: 3.039
Authors: Jon Cacicedo; Iratxe Fernandez; Olga Del Hoyo; Ainara Dolado; Javier Gómez-Suarez; Eduardo Hortelano; Aintzane Sancho; Jose I Pijoan; Julio Alvarez; Jose M Espinosa; Ayman Gaafar; Pedro Bilbao Journal: Eur J Nucl Med Mol Imaging Date: 2015-05-08 Impact factor: 9.236