Yamamoto Yuka, Wong Terence Z, Turkington Timothy G, Hawk Thomas C, Coleman R Edward
Department of Radiology, Nuclear Medicine Division, Duke University Medical Center, Durham, NC, USA.
Radiology. 2007 Jul;244(1):263-72. doi: 10.1148/radiol.2433060043. Epub 2007 May 10.
To retrospectively compare the sensitivity of a dedicated fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) protocol versus a standard whole-body PET/CT protocol for detection of head and neck cancer, with biopsy and follow-up as reference standards.
Institutional review board approval and informed consent were obtained for this HIPAA-compliant study. Dedicated and standard PET/CT protocols were performed in a phantom and in 55 patients suspected of having head and neck cancer (28 men, 27 women; age range, 21-79 years). The neck phantom contained four 4.4-9.8-mm-diameter spheres. Standard protocol consisted of a midcranium to proximal thigh emission scan of 2-4 minutes per bed position. Dedicated protocol was an 8-minute head and neck scan. Reconstructed field of view and pixel size, respectively, were 30 cm and 2.34 mm for the dedicated and 50 cm and 3.91 mm for the standard protocol. FDG uptake was evaluated visually and semiquantitatively by using standardized uptake values (SUVs). Mean SUV was compared between dedicated and standard protocols with a t test modified for clustered sampling. Receiver operating characteristic (ROC) curves were calculated. A two-tailed P value was used.
In the phantom study, a larger percentage difference (20%-27%) in sphere-to-background ratios with the dedicated than with the standard protocol was observed for 6.0-9.8-mm spheres. In the clinical study, a total of 149 lymph nodes were identified. Five malignant and six benign lymph nodes (mean diameter, 7.1 mm) were visually identified with the dedicated protocol only. SUVs with the dedicated protocol were significantly higher than those with the standard protocol (P<.001). Area under the ROC curve was 0.94 for the dedicated and 0.92 for the standard protocol (P=.56).
FDG PET with either the standard or dedicated protocol was more sensitive than CT for evaluating head and neck lymph nodes. The dedicated protocol improved the detectability of smaller nodes.
以活检及随访作为参考标准，回顾性比较专用氟代脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）方案与标准全身PET/CT方案对头颈部癌的检测敏感性。
本符合健康保险流通与责任法案（HIPAA）的研究获得了机构审查委员会的批准并取得了知情同意。在体模及55例疑似头颈部癌的患者（28例男性，27例女性；年龄范围21 - 79岁）中进行了专用及标准PET/CT方案检查。颈部体模包含4个直径4.4 - 9.8毫米的球体。标准方案包括每床位2 - 4分钟的中颅至大腿近端发射扫描。专用方案为8分钟的头颈部扫描。专用方案重建的视野和像素大小分别为30厘米及2.34毫米，标准方案分别为50厘米及3.91毫米。通过使用标准化摄取值（SUV）对视诊及半定量评估FDG摄取情况。采用针对整群抽样修正的t检验比较专用方案与标准方案之间的平均SUV。计算受试者操作特征（ROC）曲线。使用双侧P值。
在体模研究中，对于直径6.0 - 9.8毫米的球体，专用方案的球体与背景比值差异百分比（20% - 27%）大于标准方案。在临床研究中，共识别出149个淋巴结。仅通过专用方案目视识别出5个恶性及6个良性淋巴结（平均直径7.1毫米）。专用方案的SUV显著高于标准方案（P <.001）。专用方案的ROC曲线下面积为0.94，标准方案为0.92（P = 0.56）。
标准或专用方案的FDG PET在评估头颈部淋巴结方面比CT更敏感。专用方案提高了较小淋巴结的可检测性。
