Casselden Elizabeth, Sheerin Fintan, Winter Stuart C
Department of Ear, Nose, and Throat Surgery, Oxford University Hospital NHS Foundation Trust, Oxford, UK.
Department of Neuroradiology, Oxford University Hospital NHS Foundation Trust, Oxford, UK.
Eur Arch Otorhinolaryngol. 2019 Jan;276(1):243-247. doi: 10.1007/s00405-018-5203-1. Epub 2018 Dec 10.
Use of 18-FDG PET-CT is increasing in patients with head and neck cancer, enabling the identification of metastases or synchronous malignancies, but also 'incidental' disease. We aimed to establish the rate of 'incidental' findings resulting from 18-FDG PET-specific imaging, that would not have been otherwise identified on other imaging, in patients with head and neck cancer undergoing staging or surveillance of disease.
18-FDG PET-CT was performed for investigation or surveillance. Case notes were reviewed retrospectively. Unexpected findings identifiable on CT imaging alone, or by FDG-PET were recorded. For those only identifiable with FDG-PET, findings were divided into either 'incidental' or 'intentional', and benign or malignant.
93 patients underwent 18- FDG PET-CT. 86.0% had new pathology identified. 3.2% had a new malignancy identified. 37.6% had new findings on FDG-PET that would not have been identified on CT alone: 5.4% had 'intentional findings' (metastasis), and 32.3% had 'incidental findings' (synchronous malignancy or benign). 1.1% had a new malignancy on FDG-PET alone.
Intentional and incidental findings are likely on 18-FDG PET-CT. Whilst important for patient management, there is an associated emotional and financial cost, which needs acknowledgement and further investigation.
18氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（18-FDG PET-CT）在头颈癌患者中的应用日益增加，它不仅能够识别转移灶或同步性恶性肿瘤，还能发现“偶然”病变。我们旨在确定在接受疾病分期或监测的头颈癌患者中，由18-FDG PET特异性成像导致的、在其他成像检查中无法发现的“偶然”发现的发生率。
进行18-FDG PET-CT检查以进行疾病调查或监测。对病历进行回顾性审查。记录仅通过CT成像或通过FDG-PET可识别的意外发现。对于那些仅通过FDG-PET才能识别的发现，将其分为“偶然”或“有意”发现，并区分良性或恶性。
93例患者接受了18-FDG PET-CT检查。86.0%的患者发现了新的病理情况。3.2%的患者发现了新的恶性肿瘤。37.6%的患者在FDG-PET上有单独CT检查无法发现的新发现：5.4%为“有意发现”（转移灶），32.3%为“偶然发现”（同步性恶性肿瘤或良性病变）。1.1%的患者仅在FDG-PET上发现了新的恶性肿瘤。
18-FDG PET-CT检查可能会发现有意和偶然的发现。虽然这对患者管理很重要，但会带来相关的情感和经济成本，这需要得到认可并进一步研究。
