[Value of (F18)-2-fluorodeoxyglucose PET scanning in staging mouth cavity carcinoma. Comparative evaluation of PET findings before and after preoperative radiochemotherapy with histological and computerized tomography findings].
OBJECTIVE
The lack of sensitivity and specificity of conventional imaging techniques based on morphological critera is responsible for considerable limitations in the staging and surveillance of oral cancer. Therefore, this study investigates the contribution of [F18]-2-fluordesoxyglucose (FDG) positron emission tomography (PET) to tumor management with special regard to lymphnode involvement and therapeutic monitoring after radiotherapy.


METHODS
Prospective observational study.


METHODS
Twenty-one patients with advanced oral cancer, predominantly T3/T4.


METHODS
FDG-PET scans before and after preoperative radio(chemo)therapy. Standardized uptake values (SUV) were determined for the tumor site and lymphnode areas. PET scans were correlated to histological findings after ablative tumor surgery.


RESULTS
FDG-PET yielded superior sensitivity and specificity for tumor and lymphnode assessment. The effect of radiotherapy was reflected by the metabolic activity of the tumor, which shows a close correlation between the decrease of FDG uptake and histologic tumor regression. PET detected distant metastases and simultaneous tumors.


CONCLUSIONS
FDG-PET is a challenging imaging technique with the potential to improve staging procedures for oral cancer. In the monitoring of metabolic activity of the tumor in the course of radio(chemo)therapy, FDG-PET allows objective measurement of the treatment response.
Kunkel
M
M
Klinik für Mund-, Kiefer- und Gesichtschirurgie, Johannes-Gutenberg-Universität Mainz.
Wahlmann
U
U
Grötz
K A
KA
Benz
P
P
Kuffner
H D
HD
Spitz
J
J
Wagner
W
W
D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology* / Q000628:therapy; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D019788:Fluorodeoxyglucose F18