title: Use of integrated 18F-FDG PET/CT to improve the accuracy of initial cervical nodal evaluation in patients with head and neck squamous cell carcinoma.
abstract: BACKGROUND
  We investigated the accuracy of performing cervical nodal evaluation with using integrated (18)F-fluoro deoxyglucose positron emission tomography (PET)/CT for squamous cell carcinoma (SCC) of the head and neck as compared with using PET and contrast-enhanced CT (CECT) alone.
  
  
  METHODS
  The presence of metastatic lymphadenopathy in each cervical nodal group (level I-VI) and the nodal (N) classification of 47 patients with SCC of the head and neck were determined by using PET, CECT, and PET/CT, respectively, and the results were verified according to the histopathologic findings.
  
  
  RESULTS
  Among the 91 foci that had abnormal uptake on PET, the combined PET/CT images provided additional information over PET for the anatomical localization and lesion characterization of 18 sites (19.8%) in 17 patients (36.2%). PET/CT also showed the best results among the three imaging modalities for the sensitivity, specificity, and accuracy (91.8, 98.9, and 97.1%, respectively) for predicting metastatic nodes on a level-by-level analysis, and PET/CT had a higher accuracy (85.1%) for the pathologic nodal classification over the clinical examinations (68.1%) or PET (70.2%).
  
  
  CONCLUSIONS
  Combined PET/CT images are more accurate than the PET or CECT images alone for conducting cervical node evaluation in the patients suffering with head and neck SCC.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Gu, Seoul 135-710, Korea.
authors.forename: Han-Sin
authors.initials: HS
authors.lastname: Jeong
authors.forename: Chung-Hwan
authors.initials: CH
authors.lastname: Baek
authors.forename: Young-Ik
authors.initials: YI
authors.lastname: Son
authors.forename: Man
authors.initials: M
authors.lastname: Ki Chung
authors.forename: Dong
authors.initials: D
authors.lastname: Kyung Lee
authors.forename: Joon
authors.initials: J
authors.lastname: Young Choi
authors.forename: Byung-Tae
authors.initials: BT
authors.lastname: Kim
authors.forename: Hyung-Jin
authors.initials: HJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009333:Neck; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18