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Is there an additive value of 18?F-FDG PET-CT to CT/MRI for detecting nodal metastasis in oropharyngeal squamous cell carcinoma patients with palpably negative neck?

Authors
 Beomseok Sohn  ;  Yoon Woo Koh  ;  Won Jun Kang  ;  Jae-Hoon Lee  ;  Na-Young Shin  ;  Jinna Kim 
Citation
 Acta Radiologica, Vol.57(11) : 1352-1359, 2016 
Journal Title
 Acta Radiologica 
ISSN
 0284-1851 
Issue Date
2016
Abstract
Background Cervical node metastasis is one of the most significant prognostic factors in patients with oropharyngeal squamous cell carcinoma (SCC). There is little information regarding the comparison of histopathologic analysis following neck dissection with imaging results in oropharyngeal SCC. Purpose To investigate the clinical utility of PET-CT compared with computed tomography (CT) or magnetic resonance imaging (MRI) for detecting nodal metastasis in oropharyngeal SCC patients with palpably negative neck and to investigate whether pretreatment imaging modalities support the rationale for elective neck treatment. Material and Methods A total of 49 oropharyngeal SCC patients with palpably negative neck (42 men, 7 women; average age, 59.1 years) underwent primary tumor resection and neck dissection as a primary treatment. All patients were preoperatively evaluated with PET-CT and CT/MRI, and the diagnostic accuracy of each imaging modality was assessed by comparison with histopathologic results of the surgical specimen. Results Twenty-five (51.0%) of our 49 patients had neck metastases. On a level-by-level analysis, the sensitivity of PET-CT, CT/MRI, and a combination of PET-CT and CT/MRI was 54.6%, 54.6%, and 60.6%, respectively, at all neck levels. The area under the ROC showed that the diagnostic performance of the combined interpretation was not significantly different from that of CT/MRI alone (0.780 vs. 0.750, respectively; P?=?0.158) and PET-CT alone (0.780 vs. 0.765, respectively; P?=?0.501). Conclusion Addition of PET-CT to CT/MRI did not provide better diagnostic accuracy for detecting nodal metastasis in preoperative evaluation of oropharyngeal SCC patients with palpably negative neck, suggesting that current imaging studies might not replace elective neck dissection.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152905
DOI
10.1177/0284185115587544
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
강원준(Kang, Won Jun) ; 고윤우(Kho, Yoon Woo) ; 김진아(Kim, Jinna) ; 손범석(Sohn, Beomseok) ; 신나영(Shin, Na Young) ; 이재훈(Lee, Jae Hoon)
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Full Text
http://journals.sagepub.com/doi/abs/10.1177/0284185115587544
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