Nowak B, Di Martino E, Jänicke S, Cremerius U, Adam G, Zimny M, Reinartz P, Büll U
Department of Nuclear Medicine, University Hospital, Aachen University of Technology, Germany.
Nuklearmedizin. 1999;38(8):312-8.
Evaluation of F-18-FDG PET in comparison to CT/MRI as diagnostic tool in primary and recurrent head and neck cancer.
78 F-18-FDG PET studies were performed in 71 patients with known or suspected primary (n = 48) or recurrent (n = 30) head and neck cancer and compared to CT (n = 75) or MRI investigations (n = 3) concerning detection of the primary or recurrent tumor and detection of regional lymph node metastases in the ipsilateral and contralateral neck sides. Glucose uptake (SUV) of PET findings was correlated to tumor location, grading and dignity of the lesion.
Sensitivity and specificity for PET in detection of primary tumors were 87%* and 67%, respectively (CT/MRI 67%* and 44%) (*p < 0.05), in detection of local recurrence 86% and 75%, respectively (CT/MRI 57% and 92%), in detection of necks affected by lymph node metastases 80% and 92%, respectively (CT/MRI 80% and 84%). Laryngeal, buccal (cheek) and salivary gland tumors had significant lower glucose uptake (SUV) when compared to tumors of the hypopharynx (p < 0.05). G1-tumors (mean SUV 4.26) had significant (p < 0.05) lower glucose uptake when compared to G2- and G3-tumors (mean SUV 7.73 and 8.19, respectively). Mean SUV of malignant PET findings (7.88) was significant (p < 0.05) higher than mean SUV of benign PET findings (5.70). However, a SUV threshold to improve diagnostic accuracy could not be defined.
F-18-FDG PET is significantly more accurate than CT/MRI for detection of head and neck cancer. Both methods are valuable for detection of cervical lymph node metastases. Glucose uptake shows correlation to histological grading. A quantitative SUV analysis does not improve diagnostic accuracy.
评估F-18-FDG PET与CT/MRI相比，作为原发性和复发性头颈癌诊断工具的性能。
对71例已知或疑似原发性（n = 48）或复发性（n = 30）头颈癌患者进行了78次F-18-FDG PET检查，并与CT（n = 75）或MRI检查（n = 3）比较，以检测原发性或复发性肿瘤以及同侧和对侧颈部区域淋巴结转移情况。将PET检查结果的葡萄糖摄取量（SUV）与肿瘤位置、分级及病变性质相关联。
PET检测原发性肿瘤的敏感性和特异性分别为87%*和67%（CT/MRI分别为67%*和44%）（*p < 0.05）；检测局部复发时分别为86%和75%（CT/MRI分别为57%和92%）；检测受淋巴结转移影响的颈部时分别为80%和92%（CT/MRI分别为80%和84%）。与下咽肿瘤相比，喉、颊（脸颊）和唾液腺肿瘤的葡萄糖摄取量（SUV）显著更低（p < 0.05）。G1级肿瘤（平均SUV 4.26）与G2级和G3级肿瘤（平均SUV分别为7.73和8.19）相比，葡萄糖摄取量显著更低（p < 0.05）。PET恶性检查结果的平均SUV（7.88）显著高于PET良性检查结果的平均SUV（5.70）（p < 0.05）。然而，无法确定提高诊断准确性的SUV阈值。
F-18-FDG PET在检测头颈癌方面比CT/MRI显著更准确。两种方法在检测颈部淋巴结转移方面都有价值。葡萄糖摄取与组织学分级相关。定量SUV分析并不能提高诊断准确性。
