Fourth Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China.
Department of Radiology, 306 Hospital of People's Liberation Army, Beijing, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Apr;129(4):418-426. doi: 10.1016/j.oooo.2019.09.005. Epub 2019 Oct 2.
To measure the efficacy of positron emission tomography/computed tomography (PET/CT) in the diagnosis of neck metastases of oral squamous cell carcinoma (OSCC) in patients without enlarged lymph nodes and to determine the threshold of maximum standardized uptake values (SUV) in diagnosis.
In total, 78 OSCC patients without large palpable lymph nodes were included. PET/CT findings were compared with histopathologic neck status.
Neck dissection was performed in 78 patients with 98 neck sides, and 31 neck sides harbored metastases. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of PET/CT were 83.9%, 73.1%, 76.5%, 59.1%, and 90.7%, respectively. The area under the curve in receiver operating characteristic analysis was 0.76, which indicated that SUV of lymph nodes was useful in diagnosis of pathologic neck status. The threshold SUV was 2.21, which was the best diagnosis threshold of neck metastasis.
PET/CT is valuable in diagnosis of neck status. The probability of neck metastasis increased with increasing SUV values, but the threshold SUV should not be the sole criterion for determining the presence of neck metastases. Fluorodeoxyglucose PET/CT is recommended for evaluation of neck status in OSCC patients without large palpable lymph nodes.
测量正电子发射断层扫描/计算机断层扫描（PET/CT）在诊断无肿大淋巴结的口腔鳞状细胞癌（OSCC）患者颈部转移中的疗效，并确定诊断中最大标准化摄取值（SUV）的阈值。
共纳入 78 例无大触诊淋巴结的 OSCC 患者。将 PET/CT 结果与组织病理学颈部状态进行比较。
78 例患者共行 98 侧颈部淋巴结清扫术，其中 31 侧颈部有转移。PET/CT 的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为 83.9%、73.1%、76.5%、59.1%和 90.7%。受试者工作特征曲线下面积为 0.76，表明淋巴结 SUV 对诊断颈部病理状态有帮助。最佳诊断阈值 SUV 为 2.21，这是颈部转移的最佳诊断阈值。
PET/CT 对诊断颈部状态有价值。随着 SUV 值的增加，颈部转移的概率增加，但 SUV 阈值不应是确定颈部转移存在的唯一标准。建议对无大触诊淋巴结的 OSCC 患者进行氟脱氧葡萄糖 PET/CT 评估颈部状态。
