Accuracy of 18F-FDG-PET/CT for staging of oral squamous cell carcinoma

Head Neck. 2008 Nov;30(11):1488-96. doi: 10.1002/hed.20906.

Abstract

Background: This study prospectively assessed 2-[F18]-fluoro-2-deoxy-D-glucose-positron emission tomography (18F-FDG-PET)/CT (PET/CT) in oral squamous cell carcinoma.

Methods: Twenty-three patients completed preoperative TNM staging (CT, MR, whole-body fusion imaging PET/CT). In patients who underwent surgical therapy (19 of 23), TNM staging based on PET/CT scan was compared with pTNM.

Results: PET/CT correctly staged 16 of 19 primary tumors (accuracy 84.2%, sensitivity 84.2%, positive predictive value 100%) and correctly ruled out bone invasion in 3 patients with false-positive results according to CT and/or MR. PET/CT incorrectly identified neck involvement in 5 of 15 patients (3 false positives, 2 false negatives) who underwent neck dissection (accuracy 66.7%, specificity 76.9%, negative predictive value 83.3%). False-negative cases showed a nodal size not exceeding 10 mm. One patient with a bronchial synchronous primary tumor was identified.

Conclusion: PET/CT scan showed good accuracy in determining the extension and/or depth of invasion of the primary tumor. Nevertheless, PET/CT was not accurate to rule out nodal metastases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Mouth Neoplasms / diagnostic imaging*
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery
  • Neck Dissection
  • Neoplasm Staging / methods
  • Positron-Emission Tomography / methods*
  • Predictive Value of Tests
  • Prospective Studies
  • Radiopharmaceuticals
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18