title: Dual-time-point fluorodeoxyglucose positron emission tomography for diagnosis of cervical lymph node metastases in patients with head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  The purpose of this study was to evaluate whether dual-time-point fluorodeoxyglucose positron emission tomography/computed tomography image can improve nodal diagnosis in patients with head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  One hundred six HNSCC patients were enrolled. Positron emission tomography/computed tomography images were obtained twice: 1 and 2 hours after fluorodeoxyglucose injection. Maximum standardized uptake value (SUVmax) and SUVmax increasing rate (SUV-IR) were compared with the histopathologic findings to determine the optimal cutoff for nodal diagnosis.
  
  
  RESULTS
  Using early-phase image, SUVmax ≧ 2.75 was considered as optimal criterion. When using delayed-phase, SUVmax ≧ 3.5 was optimal. There was no significant difference between these criteria. Maximum standardized uptake value IR ≧ 8.0 (10/s) was considered as optimal, although it provided relatively low sensitivity (66%) and specificity (82%). However, combined criterion of SUVmax ≧ 3.5 in delayed-phase or SUV-IR ≧ 8.0 (10/s) significantly improved the specificity (90%) and accuracy (89%) without decreasing the sensitivity (84%).
  
  
  CONCLUSIONS
  Using delayed-phase image combined with SUV-IR can improve the nodal diagnosis in HNSCC patients.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan. shin.orad@tmd.ac.jp
authors.forename: Shin
authors.initials: S
authors.lastname: Nakamura
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Okochi
authors.forename: Tohru
authors.initials: T
authors.lastname: Kurabayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18