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Ann Surg. 2002 Aug;236(2):208-17.

Evaluation of 18 F-fluorodeoxyglucose positron emission tomography and computed tomography with histopathologic correlation in the initial staging of head and neck cancer.

Author information

  • 1Centre for Positron Emission Tomography, Ludwig Institute for Cancer Research, Heidelberg, Victoria, Australia. kiwi@austin.unimelb.edu.au

Abstract

OBJECTIVE:

To prospectively evaluate the use of 18F-Fluorodeoxyglucose positron emission tomography (FDG-PET) in the initial staging of squamous cell head and neck carcinoma.

SUMMARY BACKGROUND DATA:

The status of cervical lymph nodes is an important prognostic factor and determinant of management approach in squamous cell head and neck cancer.

METHODS:

FDG-PET findings were compared with those of computed tomography (CT) before removal of the primary tumor and/or neck dissection. Histopathologic analysis was used as the gold standard for assessment of the sensitivity and specificity of these modalities.

RESULTS:

FDG-PET correctly identified the primary tumor in 35 of 40 patients in whom the site of the primary was known clinically and still present (sensitivity 88%). None of four unknown primaries were detected. Tumors not detected by FDG-PET were generally superficial, with depths of less than 4 mm. CT correctly identified 18 of the 35 primary tumors (sensitivity 51%). Eleven of 17 CT false-negative tumors were detected by FDG-PET. The sensitivity and specificity for the presence of metastatic neck disease on FDG-PET were 82% and 100%, respectively; those for CT were 81% and 81%, respectively. FDG-PET was true positive for metastatic neck disease in two of the three CT false-negative patients.

CONCLUSIONS:

FDG-PET shows promise in the initial staging of head and neck cancer and provides additional accuracy to a conventional staging process using CT.

PMID:
12170026
[PubMed - indexed for MEDLINE]
PMCID:
PMC1422567
Free PMC Article
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