Department of Radiology, University of Brescia, Brescia, Italy.
Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy.
Nucl Med Rev Cent East Eur. 2021;24(2):58-62. doi: 10.5603/NMR.2021.0016.
To evaluate the diagnostic performance of [¹⁸F]fluorodeoxyglucose positron emission tomography/computed tomography ([¹⁸F]FDG-PET/CT) scan in detecting local recurrences in patients with surgically treated oral tongue squamous cell cancer (OTSCC).
Eighty-seven patients who had undergone surgery for OTSCC were monitored clinically and [¹⁸F]FDGPET/CT and magnetic resonance (MR). PET uptakes were classified as functional (Type A), suspicious (Type B), or highly suggestive of local recurrence (Type C). A multidisciplinary team (MDT) evaluated case-by-case the surveillance strategy based on PET uptake.
Fifty-nine patients presented FDG-PET uptake during follow-up: this report was significantly more frequent in patients who received flap reconstruction than in those without (73% vs 50%; p = 0.05). In 13 patients with Type A (n = 1), Type B (n = 9), and Type C (n = 3) uptakes an additional MR was considered preferable and discovered recurrence in 12.PET-CT had 9 true positives, 17 false positives, 71 true negatives, and no false-negative, resulting in sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of 100%, 80.7%, 34.6%, and 100%.
The present results demonstrated a change in diagnostic strategy, as decided by the MDT, in about one-fifth of patients. The results should prompt in designing a rational surveillance schedule in surgically treated OTSCC.
评估 [¹⁸F]氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描 ([¹⁸F]FDG-PET/CT) 在检测经手术治疗的口腔舌鳞状细胞癌 (OTSCC) 患者局部复发中的诊断性能。
对 87 例接受 OTSCC 手术治疗的患者进行临床监测和 [¹⁸F]FDG-PET/CT 和磁共振成像 (MR) 监测。PET 摄取被分类为功能性 (A型)、可疑 (B 型) 或高度提示局部复发 (C 型)。多学科团队 (MDT) 根据 PET 摄取情况对每个病例进行监测策略评估。
59 例患者在随访期间出现 FDG-PET 摄取:接受皮瓣重建的患者报告摄取的频率明显高于未接受皮瓣重建的患者 (73%比 50%;p = 0.05)。在 13 例有 A 型 (n = 1)、B 型 (n = 9) 和 C 型 (n = 3) 摄取的患者中,考虑到更偏好进行额外的 MR 检查,结果发现 12 例有复发。PET-CT 有 9 个真阳性、17 个假阳性、71 个真阴性和 0 个假阴性,敏感性、特异性、阳性预测值 (PPV) 和阴性预测值 (NPV) 分别为 100%、80.7%、34.6%和 100%。
本研究结果表明,MDT 决定改变了大约五分之一患者的诊断策略。这些结果应该促使我们设计一种合理的手术后 OTSCC 监测方案。