PURPOSE: The aim of our study was to prospectively evaluate whether intravenous contrast media in integrated positron emission tomography and computed tomography (PET/CT) with (18)F-fluorodeoxyglucose ((18)F-FDG) significantly contributes to evaluation of primary head and neck cancers compared with unenhanced PET/CT, regional contrast-enhanced CT of head and neck (neck CE-CT) and regional magnetic resonance imaging of head and neck (neck MRI). METHODS: Subjects were 42 consecutive patients (35 men, 7 women; age range: 36-91 years) with biopsy-proven primary head and neck cancers. Lesion detection of primary and nodal sites and TNM classification were assessed on a per-patient basis. McNemar test and kappa statistics were employed for statistical analyses. RESULTS: Forty patients (95%) were successfully followed up: 24 patients had nodal disease and 3 had distant metastasis. Contrast-enhanced and unenhanced PET/CT detected 98 and 95% of the primary tumours, respectively, and both detected 92% of patients with nodal disease, which revealed no statistically significant difference. Accuracy for T status was 75 and 73%, respectively, which proved significantly more accurate than neck CE-CT, which had an accuracy of 53% (p = 0.0133 and 0.0233, respectively). Neck MRI correctly classified the T status in 58% of patients; however, no statistically significant difference was found between PET/CT and neck MRI. Contrast-enhanced PET/CT, unenhanced PET/CT, neck CT and neck MRI correctly staged the N status in 90, 90, 79 and 90% of patients, respectively, with no statistically significant difference. Overall TNM classification was correctly classified in 68 and 65% of patients, respectively. Weighted kappa values between enhanced and unenhanced PET/CT for primary tumour detection, nodal detection, T status and N status were 0.655, 1.000, 0.935 and 1.000, respectively. CONCLUSION: We found almost perfect correlation between enhanced and unenhanced PET/CT for lesion detection and initial staging of primary head and neck cancers. Routine contrast administration for PET/CT imaging may not be justified.
PURPOSE: The aim of our study was to prospectively evaluate whether intravenous contrast media in integrated positron emission tomography and computed tomography (PET/CT) with (18)F-fluorodeoxyglucose ((18)F-FDG) significantly contributes to evaluation of primary head and neck cancers compared with unenhanced PET/CT, regional contrast-enhanced CT of head and neck (neck CE-CT) and regional magnetic resonance imaging of head and neck (neck MRI). METHODS: Subjects were 42 consecutive patients (35 men, 7 women; age range: 36-91 years) with biopsy-proven primary head and neck cancers. Lesion detection of primary and nodal sites and TNM classification were assessed on a per-patient basis. McNemar test and kappa statistics were employed for statistical analyses. RESULTS: Forty patients (95%) were successfully followed up: 24 patients had nodal disease and 3 had distant metastasis. Contrast-enhanced and unenhanced PET/CT detected 98 and 95% of the primary tumours, respectively, and both detected 92% of patients with nodal disease, which revealed no statistically significant difference. Accuracy for T status was 75 and 73%, respectively, which proved significantly more accurate than neck CE-CT, which had an accuracy of 53% (p = 0.0133 and 0.0233, respectively). Neck MRI correctly classified the T status in 58% of patients; however, no statistically significant difference was found between PET/CT and neck MRI. Contrast-enhanced PET/CT, unenhanced PET/CT, neck CT and neck MRI correctly staged the N status in 90, 90, 79 and 90% of patients, respectively, with no statistically significant difference. Overall TNM classification was correctly classified in 68 and 65% of patients, respectively. Weighted kappa values between enhanced and unenhanced PET/CT for primary tumour detection, nodal detection, T status and N status were 0.655, 1.000, 0.935 and 1.000, respectively. CONCLUSION: We found almost perfect correlation between enhanced and unenhanced PET/CT for lesion detection and initial staging of primary head and neck cancers. Routine contrast administration for PET/CT imaging may not be justified.
Authors: Gerhard W Goerres; Bernhard Schuknecht; Daniel T Schmid; Sandro J Stoeckli; Thomas F Hany Journal: Clin Imaging Date: 2008 Nov-Dec Impact factor: 1.605
Authors: Patrick Veit-Haibach; Christopher Luczak; Isabel Wanke; Markus Fischer; Thomas Egelhof; Thomas Beyer; Gerlinde Dahmen; Andreas Bockisch; Sandra Rosenbaum; Gerald Antoch Journal: Eur J Nucl Med Mol Imaging Date: 2007-08-24 Impact factor: 9.236
Authors: Eric M Genden; Alfio Ferlito; Alessandra Rinaldo; Carl E Silver; Johannes J Fagan; Carlos Suárez; Johannes A Langendijk; Jean Louis Lefebvre; Patrick J Bradley; C René Leemans; Amy Y Chen; Jemy Jose; Gregory T Wolf Journal: Head Neck Date: 2008-01 Impact factor: 3.147