Impact of FDG-PET/CT Imaging on Nodal Staging for Head-And-Neck Squamous Cell Carcinoma
- Department of Radiation Oncology, Kumamoto University Hospital, Kumamoto (Japan)
- Uozumi Clinic, Kumamoto (Japan)
- Department of Diagnostic Radiology, Kumamoto University Hospital, Kumamoto (Japan)
- Department of Radiology, Kumamoto Chuo Hospital, Kumamoto (Japan)
- Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto (Japan)
- Department of Medical Information Systems, Kumamoto University School of Health Sciences, Kumamoto (Japan)
Purpose: To evaluate the impact of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging on nodal staging for head-and-neck squamous cell carcinoma (SCC). Methods and Materials: The study population consisted of 23 patients with head-and-neck SCC who were evaluated with FDG-PET/CT and went on to neck dissection. Two observers consensually determined the lesion size and maximum standardized uptake value (SUV{sub max}) and compared the results with pathologic findings on nodal-level involvement. Two different observers (A and B) independently performed three protocols for clinical nodal staging. Methods 1, 2, and 3 were based on conventional modalities, additional visual information from FDG-PET/CT images, and FDG-PET/CT imaging alone with SUV data, respectively. Results: All primary tumors were visualized with FDG-PET/CT. Pathologically, 19 positive and 93 negative nodal levels were identified. The SUV{sub max} overlapped in negative and positive nodes <15 mm in diameter. According to receiver operating characteristics analysis, the size-based SUV{sub max} cutoff values were 1.9, 2.5, and 3.0 for lymph nodes <10 mm, 10-15 mm, and >15 mm, respectively. These cutoff values yielded 79% sensitivity and 99% specificity for nodal-level staging. For Observer A, the sensitivity and specificity in Methods 1, 2, and 3 were 68% and 94%, 68% and 99%, and 84% and 99%, respectively, and Method 3 yielded significantly higher accuracy than Method 1 (p = 0.0269). For Observer B, Method 3 yielded the highest sensitivity (84%) and specificity (99%); however, the difference among the three protocols was not statistically significant. Conclusion: Imaging with FDG-PET/CT with size-based SUV{sub max} cutoff values is an important modality for radiation therapy planning.
- OSTI ID:
- 20951655
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 68, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2006.12.032; PII: S0360-3016(06)03635-2; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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