Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Head Neck. 2021 Jul;43(7):2058-2068. doi: 10.1002/hed.26668. Epub 2021 Mar 17.
To assess the effect of 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in the pretherapeutic staging of N classification, detection rate of distant metastases, and second primaries.
Retrospective study on patients with head and neck carcinoma. We compared pretherapeutic N classification by ultrasound, computed tomography (CT)/magnetic resonance imaging (MRI), and FDG-PET-CT/MRI.
A change in the N classification due to FDG-PET-CT/MRI was observed in 116 patients (39.5%) compared to N classification by ultrasound and fine-needle aspiration cytology. Patients with advanced nodal classification (>N2a) were more likely to be reclassified. Distant metastases were detected in 19 patients and a total of 36 second primaries were diagnosed by FDG-PET-CT/MRI. Detection of distant metastases was more likely in regional advanced disease (>N2a). Smokers (>10 py) had a significantly higher risk of second primary.
FDG-PET-CT/MRI leads to a significant change in pretherapeutic N classification. The cumulative incidence of distant metastases and second primaries was 18.7%.
评估 18-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）在 N 分期、远处转移和第二原发癌的术前分期中的作用。
对头颈癌患者进行回顾性研究。我们比较了超声、计算机断层扫描（CT）/磁共振成像（MRI）和 FDG-PET-CT/MRI 对术前 N 分期的评估。
与超声和细针抽吸细胞学相比，116 例患者（39.5%）的 N 分期因 FDG-PET-CT/MRI 而发生变化。更高级别的淋巴结分类（>N2a）患者更有可能被重新分类。19 例患者检测到远处转移，36 例第二原发癌通过 FDG-PET-CT/MRI 诊断。局部晚期疾病（>N2a）的远处转移检测率更高。吸烟（>10 支/天）患者第二原发癌的风险显著增加。
FDG-PET-CT/MRI 导致术前 N 分期发生显著变化。远处转移和第二原发癌的累积发生率为 18.7%。
