The clinical usefulness of (18)F-FDG PET/CT for the evaluation of lymph node metastasis in periorbital malignancies.
OBJECTIVE
The aim of this study was to assess the clinical role of (18)F-FDG PET/CT for the evaluation of lymph node metastasis in periorbital malignancies, compared with CT alone.


METHODS
We analyzed eighteen PET/CT and CT scans in 15 patients with biopsy-proven periorbital malignancies. We compared the diagnostic capabilities of PET/CT and CT with regard to nodal metastasis by level-by-level analysis and by N staging prediction. The reference standards were surgical pathology (n = 7) from dissected lymph node specimens and the results from radiological follow-up (n = 11, mean 20.5 months; range 10-52 months). Moreover, any changes in patient care as prompted by PET/CT were recorded and compared with treatment planning for CT alone.


RESULTS
PET/CT had a sensitivity of 100%, while CT had a sensitivity of 57% (p = 0.03) for nodal metastasis by level-by-level analysis. PET/CT had a specificity of 97%, positive predictive value of 93%, negative predictive value of 100%, and diagnostic accuracy of 98%, while the CT values for these same parameters were 97%, 89%, 82%, and 84%, respectively. PET/CT correctly predicted N staging with an accuracy of 100%, while CT was only 83% accurate (p = 0.01). Regarding the impact on patient care, the extent of surgery for regional lymph nodes and the treatment decision were modified by PET/CT in 39% of patients.


CONCLUSIONS
PET/CT could provide useful information in the management of regional lymph node metastases in patients with periorbital malignancies.
Baek
Chung Hwan
CH
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Chung
Man Ki
MK
Jeong
Han Sin
HS
Son
Young Ik
YI
Choi
Jeesun
J
Kim
Yoon Duck
YD
Choi
Joon Young
JY
Kim
Hyung Jin
HJ
Ko
Young Hyeh
YH
D000328:Adult; D000368:Aged; D003287:Contrast Media; D005134:Eye Neoplasms / Q000473:pathology / Q000556:secondary*; D005142:Eyelid Neoplasms / Q000473:pathology / Q000556:secondary; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D007766:Lacrimal Apparatus Diseases / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D007472:Iohexol; C038192:iopromide