Ashutosh Chauhan1, Pranjal Kulshrestha2, Sanjay Kapoor3, Harkirat Singh4, M J Jacob5, Maneel Patel6, Manomoy Ganguly7. 1. Classified Specialist (Surgery & Oncosurgeon), Command Hospital (CC), Lucknow, India. 2. Resident, Oncology Center, AH (R&R), New Delhi, India. 3. Consultant (Surgery & Oncosurgery), Command Hospital (CC), Lucknow, India. 4. Senior Advisor (Nuclear Medicine), Command Hospital (SC), Pune 411040, India. 5. Senior Advisor (Nuclear Medicine), INHS Asvini, Colaba, Mumbai, India. 6. Classified Specialist (Radiodiagnosis), INHS Dhanvantari, Port Blair, India. 7. Commandant, Military Hospital, Roorkee, India.
Abstract
BACKGROUND: Evaluation of a clinically N0 neck is mandatory in cases of squamous cell carcinoma of head and neck region in order to determine the need to address the neck. The study was designed to compare the accuracy of PET/CT scan with that of USG and CECT Neck in assessing clinically N0 neck in cases of squamous cell carcinoma of upper aerodigestive tract. METHODS: Single center, prospective, study over a 2 year period. All Cases of squamous cell carcinoma of upper aerodigestive tract with no palpable neck lymphadenopathy and who were scheduled for surgery were evaluated with USG, CECT and 18F-FDG PET/CT, of the neck. Post operative histopathology was correlated with pre-operative nodal status. Statistical analysis was done using the chi square test. RESULTS: In the 49 patients enrolled, 51 neck sides underwent dissections. Sensitivity of USG, CECT and PET-CT was 4.76%, 23.80% and 71.43% respectively while the specificity was 93.33%, 93.33% and 96.67% respectively. The positive predictive value (PPV) calculated for USG, CECT and PET-CT was 33.33%, 71%, 93.5% respectively while the negative predictive value (NPV) 58.33%, 63.63% and 82.85% respectively. CONCLUSIONS: In N0 neck in head and neck squamous cell carcinoma, though FDG-PET-CT is more accurate than either USG or CECT in staging of the neck, it is not accurate enough to alter the current treatment paradigm.
BACKGROUND: Evaluation of a clinically N0 neck is mandatory in cases of squamous cell carcinoma of head and neck region in order to determine the need to address the neck. The study was designed to compare the accuracy of PET/CT scan with that of USG and CECT Neck in assessing clinically N0 neck in cases of squamous cell carcinoma of upper aerodigestive tract. METHODS: Single center, prospective, study over a 2 year period. All Cases of squamous cell carcinoma of upper aerodigestive tract with no palpable neck lymphadenopathy and who were scheduled for surgery were evaluated with USG, CECT and 18F-FDG PET/CT, of the neck. Post operative histopathology was correlated with pre-operative nodal status. Statistical analysis was done using the chi square test. RESULTS: In the 49 patients enrolled, 51 neck sides underwent dissections. Sensitivity of USG, CECT and PET-CT was 4.76%, 23.80% and 71.43% respectively while the specificity was 93.33%, 93.33% and 96.67% respectively. The positive predictive value (PPV) calculated for USG, CECT and PET-CT was 33.33%, 71%, 93.5% respectively while the negative predictive value (NPV) 58.33%, 63.63% and 82.85% respectively. CONCLUSIONS: In N0 neck in head and neck squamous cell carcinoma, though FDG-PET-CT is more accurate than either USG or CECT in staging of the neck, it is not accurate enough to alter the current treatment paradigm.
Authors: Francisco J Civantos; Carmen Gomez; Carlos Duque; Felipe Pedroso; William Jarrard Goodwin; Donald T Weed; David Arnold; Fred Moffat Journal: Head Neck Date: 2003-01 Impact factor: 3.147
Authors: Val J Lowe; Fenghai Duan; Rathan M Subramaniam; JoRean D Sicks; Justin Romanoff; Twyla Bartel; Jian Q Michael Yu; Brian Nussenbaum; Jeremy Richmon; Charles D Arnold; David Cognetti; Brendan C Stack Journal: J Clin Oncol Date: 2019-02-15 Impact factor: 44.544