Volume 21, Number 3 & 4, September & December 2009
| | 18F-Fluorodeoxyglucose Positron Emission Tomography–computed Tomography for Diagnosis of Cervical Lymph Node Metastases of Oral Squamous Cell Carcinoma |
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Hidetomo Nishikawa,1 Koh-Ichi Nakashiro,1 Tomoki Sumida,1 Masao Miyagawa,2 Hiroyuki Hamakawa1
1Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, and 2Department of Radiology, Ehime Prefectural Central Hospital, Ehime, Japan
Abstract
Objective: 18F-Fluorodeoxyglucose positron emission tomography–computed tomography is increasingly being used for the diagnosis of primary malignant tumours, cervical lymph node metastases, and distant metastases. As cervical lymph node metastasis is a particularly important prognostic factor for patients with cancers of the head and neck, this study was performed to ascertain the efficacy of this technique for the diagnosis of such metastases in patients with oral squamous cell carcinoma.
Patients and Methods: 123 cervical lymph nodes were analysed from 21 patients, who underwent preoperative diagnosis by 18F-fluorodeoxyglucose positron emission tomography–computed tomography in addition to other conventional diagnostic procedures, such as computed tomography and magnetic resonance imaging. Lymph nodes were removed by sentinel lymph node biopsy or neck dissection and were examined histopathologically for metastasis.
Results: Seven patients were metastasis-positive. The optimal cut-off for the maximum standardised uptake value for 18F-fluorodeoxyglucose positron emission tomography–computed tomography in assessing lymph node metastases was 4.1, which had the highest diagnostic accuracy (sensitivity, 100%; specificity, 100%; accuracy, 100%). Of the 13 lymph nodes identified as metastasis-positive by histological examinations, 12 (92.3%) also tested positive using 18F-fluorodeoxyglucose positron emission tomography–computed tomography.
Conclusion: These results suggest that 18F-fluorodeoxyglucose positron emission tomography–computed tomography is useful for detecting cervical lymph node metastasis.
Key words: Carcinoma, squamous cell, Lymph nodes, Neck, Neoplasm metastasis, Positron-emission tomography
Asian J Oral Maxillofac Surg. 2009;21:88-95.
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