Lymph Node Detection of Head and Neck Squamous Cell Carcinomas by Positron Emission Tomography With Fluorodeoxyglucose F 18 in a Routine Clinical Setting

Open Access
Publisher Website
Google Scholar
Abstract
ACCURATE pretherapeutic lymph node staging is mandatory for planning surgical strategy (type of neck dissection and 1 or both sides) in patients with resectable head and neck squamous cell carcinomas (SCCs). In patients with nonresectable primary tumors, an individualized radiation field also requires precise definition of metastatic lymph node involvement. Until now, the definition of malignant lymph node involvement was based on morphologic changes as determined by computed tomography (CT) or magnetic resonance imaging (MRI). These procedures mainly lack sensitivity, because of malignant involvement in nonenlarged lymph nodes (false negatives), and specificity, because of reactive, nonmalignant enlargement of lymph nodes (false positives). Metabolic factors such as glycolysis are independent of morphologic changes, and the increase of these factors is measureable in malignant tumors. Thus, previous studies1,2 showed that lymph node staging of head and neck SCCs by positron emission tomography (PET) with fluorodeoxyglucose F 18 is more precise than morphologic procedures such as CT and MRI. To our knowledge, all published studies have been performed in selected patient groups. In this study, we compared the diagnostic accuracy of PET, CT, and MRI for lymph node involvement in nonselected patients in a routine clinical setting.