Division of Medical Oncology, Department of Internal Medicine, Gazi University Faculty of Medicine, Besevler, Ankara 06500, Turkey.
Eur Arch Otorhinolaryngol. 2013 Aug;270(8):2307-13. doi: 10.1007/s00405-012-2337-4. Epub 2013 Jan 3.
The objective of the study was to evaluate the impact of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) imaging on nodal staging for head and neck cancers. This was a retrospectively analyzed single institution study. The study population consisted of 36 patients with head and neck cancers who were evaluated with PET/CT and went on to neck dissection. All of them had clinically and radiographically negative neck (N₀) and each patient underwent PET/CT imaging before undergoing selective neck dissection for N₀ disease. Tissues were submitted for histopathologic examination and were oriented for the pathologist to permit correlation between the histopathologic findings and the imaging results. The sizes of the lymph nodes and the maximum standardized uptake values (SUVmax) measured from PET/CT images were compared with the histopathologic findings. All primary tumors were visualized with PET/CT. On histopathological examination, 19 patients had positive and 17 patients had negative lymph nodes. Receiver operating characteristic analyses were used to predict the optimal corrected SUVmax cutoffs; the optimal value was 2.95 for respective outcomes of lymph node involvement. This cutoff value yielded 84.2% sensitivity and 76.5% specificity for nodal-level staging. PET/CT proved to be accurate in 27 (75%) patients and inaccurate in 9 (25%) patients. PET/CT was a valuable tool to assess nodal stage of head and neck cancers, and should be considered before surgical treatment.
本研究旨在评估 18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）成像对头颈部癌症淋巴结分期的影响。这是一项回顾性分析的单机构研究。研究人群包括 36 例经 PET/CT 评估后行颈部解剖的头颈部癌症患者。所有患者均有临床和影像学阴性的颈部（N0），且每位患者均在选择性 N0 疾病颈部解剖前行 PET/CT 成像。对组织进行组织病理学检查，并对其进行定向处理，以允许病理学家将组织病理学发现与成像结果进行相关。比较了来自 PET/CT 图像的淋巴结大小和最大标准化摄取值（SUVmax）与组织病理学发现的关系。所有原发肿瘤均经 PET/CT 可视化。在组织病理学检查中，19 例患者淋巴结阳性，17 例患者淋巴结阴性。使用受试者工作特征分析来预测最佳校正 SUVmax 截断值；分别为淋巴结受累的最佳值为 2.95。该截断值对淋巴结水平分期的敏感性为 84.2%，特异性为 76.5%。PET/CT 在 27 例（75%）患者中准确，在 9 例（25%）患者中不准确。PET/CT 是评估头颈部癌症淋巴结分期的有效工具，应在手术治疗前考虑使用。
