Detection of cervical metastases with (11)C-tyrosine PET in patients with squamous cell carcinoma of the oral cavity or oropharynx: A comparison with (18)F-FDG PET.
BACKGROUND
A disadvantage of 2-[(18)F]fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography (PET) in head and neck cancer is that (18)F-FDG uptake is not specific to malignant tissue. To provide an alternative, radiolabeled amino acids such as L-1-[(11)C]-tyrosine ((11)C-TYR), were introduced because these are less avidly metabolized by inflammatory cells.


METHODS
In this prospective study, we compared both (11)C-TYR PET and (18)F-FDG PET performance in detecting cervical metastases in 27 patients with a squamous cell carcinoma (SCC) of oral cavity or oropharynx.


RESULTS
(11)C-TYR PET sensitivity, specificity, and accuracy for detecting nodal metastases were 33%, 100%, and 81%, respectively. With respect to (18)F-FDG PET, these figures were 67%, 97%, and 89%, respectively. Neck metastases not detected by (11)C-TYR PET were camouflaged by high tracer uptake by salivary glands.


CONCLUSIONS
Because of bilateral accumulation of (11)C-TYR in salivary glands, (11)C-TYR PET is not suitable to replace (18)F-FDG PET in staging SCC of oral cavity and oropharynx.
Krabbe
Christiaan A
CA
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, The Netherlands. c.a.krabbe@kchir.umcg.nl
van der Werff-Regelink
Gerreke
G
Pruim
Jan
J
van der Wal
Jacqueline E
JE
Roodenburg
Jan L N
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002250:Carbon Radioisotopes; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D014443:Tyrosine
D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D014443:Tyrosine