title: Staging of untreated squamous cell carcinoma of buccal mucosa with 18F-FDG PET: comparison with head and neck CT/MRI and histopathology.
abstract: This prospective, nonrandomized, case-control study evaluated the impact of (18)F-FDG PET in staging untreated squamous cell carcinoma of the buccal mucosa (BSCC) and compared the results with CT/MRI and histopathology.
  
  
  METHODS
  Between January 2002 and April 2004, 102 untreated BSCC patients with cM0 (no evidence of distant metastatic focus on chest radiograph, liver ultrasonograph, and bone scan) were enrolled with either conventional work-up (CWU, n = 51) or PET (CWU+PET, n = 51). All were monitored for at least 6 mo. The comparative diagnostic efficacies of PET and CT/MRI were evaluated using the area under the receiver-operating-characteristic curve (AUC). The primary endpoint was the percentage reduction in futile surgery (preoperative detection of distant metastatic lesions). The secondary endpoint was the 2-y cumulative recurrence rate among study participants (with PET) compared with that of comparable control subjects (without PET).
  
  
  RESULTS
  Significant benefits of PET compared with those of CT/MRI for BSCC patients were in the detection of locoregional (AUC, 0.973 vs. 0.928; P = 0.026), regional (AUC, 0.939 vs. 0.837; P = 0.026), and level II (AUC, 0.974 vs. 0.717; P = 0.02) lymph nodes. Two percent (1/51) of the patients experienced a reduction in futile surgery in the CWU+PET group compared with 0% (0/51) in the CWU group. However, no statistical difference was found in the 2-y locoregional control rate between the CWU and the CWU+PET groups.
  
  
  CONCLUSIONS
  The role of (18)F-FDG PET for BSCC with cM0 is limited. Although PET is superior to CT/MRI in identifying cervical nodal metastases, it does not improve locoregional recurrence.
authors.affiliation: Department of Nuclear Medicine, Chang Gung Memorial Hospital Linkou Medical Center, 5 Fu-Shin Street, Kueishan, Taoyuan 133, Taiwan.
authors.forename: Tzu-Chen
authors.initials: TC
authors.lastname: Yen
authors.forename: Joseph Tung-Chieh
authors.initials: JT
authors.lastname: Chang
authors.forename: Shu-Hang
authors.initials: SH
authors.lastname: Ng
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Chang
authors.forename: Sheng-Chieh
authors.initials: SC
authors.lastname: Chan
authors.forename: Hung-Ming
authors.initials: HM
authors.lastname: Wang
authors.forename: Lai-Chu
authors.initials: LC
authors.lastname: See
authors.forename: Tsung-Ming
authors.initials: TM
authors.lastname: Chen
authors.forename: Chung-Jan
authors.initials: CJ
authors.lastname: Kang
authors.forename: Yi-Fen
authors.initials: YF
authors.lastname: Wu
authors.forename: Kun-Ju
authors.initials: KJ
authors.lastname: Lin
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Liao
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000000981:diagnostic imaging*; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18