Li Chun-Yan, Klohr Sarah, Sadick Haneen, Weiss Christel, Hoermann Karl, Schoenberg Stefan O, Sadick Maliha
Institute of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Heidelberg, Germany Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Institute of Clinical Radiology and Nuclear Medicine, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Heidelberg, Germany.
J Nucl Med Technol. 2014 Sep;42(3):181-7. doi: 10.2967/jnmt.114.141192. Epub 2014 Jun 26.
Precise assessment of lymph node metastases is critical to the treatment outcome and overall survival of patients with head and neck squamous cell carcinoma (HNSCC). The purpose of this study was to investigate the effect of time-of-flight (TOF) technique on the diagnostic performance of (18)F-FDG PET/CT for assessment of lymph node metastases in HNSCC patients.
In 39 patients with an initial diagnosis of HNSCC, preoperative staging (18)F-FDG PET/CT was performed to assess lymph node metastases before surgery and histologic verification. Potential lymph node metastases were evaluated and documented separately for the right and left neck in accordance with the head and neck lymph node level classification. Two experienced readers measured lesion volume and uptake for every PET-positive lymph node. Sensitivity, specificity, image quality, and the PET characterization of the lesion (benign or malignant) were compared between different reconstruction methods (TOF PET and standard high-definition PET) and matrices for both readers.
TOF PET significantly increased the maximal standardized uptake value (SUVmax) but had no significant effect on lesion volume. However, a higher SUVmax did not result in a significant increase in small-lesion detection. Sensitivity and image quality were slightly improved with TOF PET but not significantly so. Matrix, on the other hand, had a significant effect on detected lesion numbers, sensitivity, and image quality.
For preoperative assessment of lymph node metastases in HNSCC, (18)F-FDG PET/CT using TOF technique increases SUVmax in lesions and improves image quality but has no significant impact on small-lesion detectability.
精确评估淋巴结转移对于头颈部鳞状细胞癌（HNSCC）患者的治疗结果和总生存期至关重要。本研究的目的是探讨飞行时间（TOF）技术对18F-FDG PET/CT诊断HNSCC患者淋巴结转移性能的影响。
对39例初诊为HNSCC的患者，术前行18F-FDG PET/CT检查以评估术前淋巴结转移情况并进行组织学验证。根据头颈部淋巴结水平分类，分别对左右颈部潜在的淋巴结转移进行评估和记录。两位经验丰富的阅片者测量每个PET阳性淋巴结的病变体积和摄取情况。比较两位阅片者在不同重建方法（TOF PET和标准高清PET）及矩阵下的敏感性、特异性、图像质量和病变的PET特征（良性或恶性）。
TOF PET显著提高了最大标准化摄取值（SUVmax），但对病变体积无显著影响。然而，较高的SUVmax并未导致小病变检测率显著增加。TOF PET使敏感性和图像质量略有改善，但不显著。另一方面，矩阵对检测到的病变数量、敏感性和图像质量有显著影响。
对于HNSCC患者术前淋巴结转移的评估，采用TOF技术的18F-FDG PET/CT可增加病变的SUVmax并改善图像质量，但对小病变的可检测性无显著影响。
