Seymour N, Burkill G, Harries M
Department of Otolaryngology,Brighton and Sussex University Hospitals NHS Trust,Brighton,UK.
Department of Radiology,Brighton and Sussex University Hospitals NHS Trust,Brighton,UK.
J Laryngol Otol. 2018 Mar;132(3):270-274. doi: 10.1017/S002221511700247X. Epub 2017 Dec 18.
Positron emission tomography-computed tomography with fluorine-18 fluorodeoxy-D-glucose has a major role in the investigation of head and neck cancers. Fluorine-18 fluorodeoxy-D-glucose is not a tumour-specific tracer and can also accumulate in benign pathology. Therefore, positron emission tomography-computed tomography scan interpretation difficulties are common in the head and neck, which can produce false-positive results. This study aimed to investigate patients detected as having abnormal vocal fold uptake on fluorine-18 fluorodeoxy-D-glucose positron emission tomography-computed tomography.
Positron emission tomography-computed tomography scans were identified over a 15-month period where reports contained evidence of unilateral vocal fold uptake or vocal fold pathology. Patients' notes and laryngoscopy results were analysed.
Forty-six patients were identified as having abnormal vocal fold uptake on positron emission tomography-computed tomography. Twenty-three patients underwent positron emission tomography-computed tomography and flexible laryngoscopy: 61 per cent of patients had true-positive positron emission tomography-computed tomography scans and 39 per cent had false-positive scan results.
Most patients referred to ENT for abnormal findings on positron emission tomography-computed tomography scans had true-positive findings. Asymmetrical fluorine-18 fluorodeoxy-D-glucose uptake should raise suspicion of vocal fold pathology, accepting a false-positive rate of approximately 40 per cent.
氟-18氟脱氧-D-葡萄糖正电子发射断层扫描-计算机断层扫描在头颈部癌症的检查中起主要作用。氟-18氟脱氧-D-葡萄糖不是肿瘤特异性示踪剂，也可在良性病变中积聚。因此，正电子发射断层扫描-计算机断层扫描的解读困难在头颈部很常见，可能产生假阳性结果。本研究旨在调查在氟-18氟脱氧-D-葡萄糖正电子发射断层扫描-计算机断层扫描中被检测出声带摄取异常的患者。
在15个月的时间里对正电子发射断层扫描-计算机断层扫描进行识别，这些报告包含单侧声带摄取或声带病变的证据。分析患者病历和喉镜检查结果。
46例患者在正电子发射断层扫描-计算机断层扫描中被确定为声带摄取异常。23例患者接受了正电子发射断层扫描-计算机断层扫描和软性喉镜检查：61%的患者正电子发射断层扫描-计算机断层扫描结果为真阳性，39%的患者扫描结果为假阳性。
大多数因正电子发射断层扫描-计算机断层扫描结果异常而转诊至耳鼻喉科的患者有真阳性结果。氟-18氟脱氧-D-葡萄糖摄取不对称应引起对声带病变的怀疑，假阳性率约为40%。
