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Radiology. 2010 May;255(2):578-85. doi: 10.1148/radiol.10091479.

Squamous cell carcinoma of the palatine tonsils: FDG standardized uptake value ratio as a biomarker to differentiate tonsillar carcinoma from physiologic uptake.

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1
Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, Level 3, Boston, MA 02118, USA.

Abstract

PURPOSE:

To quantify fluorine 18 ((18)F) fluorodeoxyglucose (FDG) uptake in the palatine tonsils to identify a sensitive and specific metric for distinguishing physiologic asymmetric uptake from squamous cell carcinoma (SCC).

MATERIALS AND METHODS:

This HIPAA-compliant retrospective study was approved by institutional review board. Informed consent requirements were waived. Twenty-six patients (seven female, 19 male; mean age, 53.46 years + or - 10.45 [standard deviation]) with tonsillar SCC were included. Twenty-six patients (seven female, 19 male; mean age, 61.77 years + or - 10.12) with head and neck carcinomas not involving the tonsils were included as control subjects. Tonsil standardized uptake values (SUVs) were measured bilaterally in each group. Independent-samples t test was used to compare mean SUVs, and Pearson correlation was used to evaluate association of FDG uptake between tonsils within control subjects.

RESULTS:

The mean maximum SUV (SUV(max)) of tonsil tumors was 9.36 + or - 4.54, which was significantly higher than that of contralateral cancer-free tonsils (2.54 + or - 0.88; P < .0001) and tonsils in control subjects (2.98 + or - 1.08; P < .0001). In patients with tonsillar cancer, the mean difference in SUV(max) between tonsils was 10.43 + or - 7.07, which was significantly greater than that in control subjects (0.62 + or - 0.54; P < .0001). The mean SUV(max) ratio between tonsils in patients with carcinoma was 3.79 + or - 1.69, which was threefold higher than in control subjects (1.18 + or - 0.13; P < .0001). For receiver operating characteristic analysis using SUV(max) ratio to differentiate benign uptake from SCC, the area under the curve was 1.00 (95% confidence interval: 1.00, 1.00). A cutoff ratio of 1.48 had 100% sensitivity and specificity.

CONCLUSION:

The SUV(max) ratio represents an accurate imaging biomarker for differentiating tonsillar SCC from physiologic (18)F-FDG uptake.

PMID:
20413767
DOI:
10.1148/radiol.10091479
[Indexed for MEDLINE]
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