Di Martino E, Nowak B, Hassan H A, Hausmann R, Adam G, Buell U, Westhofen M
Department of Ear, Nose, and Throat Diseases, University of Aachen, Germany.
Arch Otolaryngol Head Neck Surg. 2000 Dec;126(12):1457-61. doi: 10.1001/archotol.126.12.1457.
To compare the clinical value of positron emission tomography (PET) using fludeoxyglucose F 18, computed tomography (CT), color-coded duplex sonography (CCDS), and panendoscopy in the detection and staging of head and neck cancer.
Prospective nonrandomized controlled study.
Medical school.
Convenience sample of 50 patients with suspected primary or recurrent head and neck cancer.
Biopsy, tumor surgery.
Information of diagnostic procedures compared with histopathologic features.
Both PET and panendoscopy had a sensitivity of 95% and 100% for detection of primary tumor or recurrent carcinomas, respectively. Specificity for PET and panendoscopy was 92% and 85% in primary tumors and 100% and 80% in recurrent carcinoma, respectively. Sensitivity of CCDS and CT was 74% and 68% in primary tumors and 67% and 63% in recurrent carcinomas, respectively. Specificity was 75% and 69% in primary tumors and 100% and 80% in recurrent neoplasms. When assessing neck nodes, all imaging procedures exhibited identical sensitivity (84%). Specificity was 90%, 96%, and 88% in PET, CT, and CCDS, respectively. In recurrent lymph node metastases, sensitivity was 100%, 67%, and 67% and specificity was 87%, 91%, and 87% for PET, CT, and CCDS, respectively.
Positron emission tomography was the most reliable imaging procedure in the detection of primary tumor and recurrent carcinomas localized in the head and neck region. Owing to its limited anatomical depiction, it cannot as yet replace other diagnostic procedures in preoperative planning but does contribute valuable complementary diagnostic information. Computed tomograpy may have difficulties in identifying recurrent carcinomas. For routine diagnosis of nodal spread in the neck, CCDS is recommended. Panendoscopy is a valuable diagnostic procedure that can provide key information in cases of superficial mucosal tumor involvement. Arch Otolaryngol Head Neck Surg. 2000;126:1457-1461
比较使用氟脱氧葡萄糖F 18的正电子发射断层扫描（PET）、计算机断层扫描（CT）、彩色编码双功超声检查（CCDS）和全内镜检查在头颈部癌检测及分期中的临床价值。
前瞻性非随机对照研究。
医学院。
50例疑似原发性或复发性头颈部癌患者的便利样本。
活检、肿瘤手术。
将诊断程序的信息与组织病理学特征进行比较。
PET和全内镜检查对原发性肿瘤或复发性癌的检测敏感性分别为95%和100%。PET和全内镜检查在原发性肿瘤中的特异性分别为92%和85%，在复发性癌中分别为100%和80%。CCDS和CT在原发性肿瘤中的敏感性分别为74%和68%，在复发性癌中分别为67%和63%。原发性肿瘤的特异性分别为75%和69%，复发性肿瘤的特异性分别为100%和80%。在评估颈部淋巴结时，所有成像检查的敏感性均相同（84%）。PET、CT和CCDS的特异性分别为90%、96%和88%。在复发性淋巴结转移中，PET、CT和CCDS的敏感性分别为100%、67%和67%，特异性分别为87%、91%和87%。
正电子发射断层扫描是检测头颈部区域原发性肿瘤和复发性癌最可靠的成像检查。由于其解剖显示有限，它目前还不能在术前规划中取代其他诊断程序，但确实提供了有价值的补充诊断信息。计算机断层扫描在识别复发性癌方面可能存在困难。对于颈部淋巴结转移的常规诊断，建议使用CCDS。全内镜检查是一种有价值的诊断程序，在浅表黏膜肿瘤受累的病例中可提供关键信息。《耳鼻喉头颈外科文献》。2000年；126:1457 - 1461
