1 Department of Otolaryngology, Johns Hopkins University, Baltimore, Maryland, USA.
2 Division of Otolaryngology, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA.
Otolaryngol Head Neck Surg. 2018 Mar;158(3):484-488. doi: 10.1177/0194599817742579. Epub 2017 Nov 21.
Objective 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) imaging is common in head and neck cancer and often identifies incidental findings that necessitate additional patient evaluations. Our goal was to assess the frequency and nature of these incidental imaging findings on FDG-PET/CT. Study Design Retrospective cohort study. Setting Tertiary medical center. Subjects and Methods All patients with head and neck cancer who had undergone FDG-PET/CT imaging between January 2014 and June 2015 at our institution were evaluated for incidental findings. Results A total of 293 patients met criteria; more than one-third (n = 103) had at least 1 finding unrelated to their head and neck cancer, for a total of 134 incidental findings. Incidental findings within the head and neck (33.5% of all) excluding the thyroid were most common: 35% incidental findings were concerning for malignancy; of these, 25.5% were malignant with further workup. Recommendations were given by the head and neck radiologist on 72 (53.7%) findings: 74.5% of potentially malignant findings and 42.5% of benign findings had recommendations for follow-up. Significantly more patients with findings described as malignant were given recommendations for follow-up ( P = .0004). Conclusion Incidental findings on FDG-PET/CT are present in more than one-third of patients with head and neck cancer. More than one-third of incidental findings were concerning for malignancy. This study illustrates how the incidental findings discovered on FDG PET/CT frequently necessitate additional evaluations unrelated to the index head and neck cancer. The impact of these additional assessments on the cost and quality of health care warrants future evaluation.
18F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）成像在头颈部癌症中很常见，经常会发现需要进一步评估的偶然发现。我们的目标是评估 FDG-PET/CT 上这些偶然成像发现的频率和性质。
回顾性队列研究。
三级医疗中心。
对 2014 年 1 月至 2015 年 6 月期间在我院接受 FDG-PET/CT 成像的所有头颈部癌症患者进行了偶然发现的评估。
共有 293 名患者符合标准；超过三分之一（n=103）有至少 1 个与头颈部癌症无关的发现，总共 134 个偶然发现。除甲状腺外，头颈部（所有偶然发现的 33.5%）内的偶然发现最常见：35%的偶然发现提示恶性肿瘤；其中，25.5%经进一步检查为恶性。头颈部放射科医生对 72 个（53.7%）发现提出了建议：53.7%的潜在恶性发现和 42.5%的良性发现建议随访。有更多被描述为恶性的发现患者被建议进行随访（P=0.0004）。
在超过三分之一的头颈部癌症患者中，FDG-PET/CT 上存在偶然发现。超过三分之一的偶然发现提示恶性肿瘤。本研究说明了在 FDG PET/CT 上偶然发现的偶然发现经常需要进行与索引头颈部癌症无关的额外评估。这些额外评估对医疗保健的成本和质量的影响值得未来评估。
