title: Evaluation of 18F-FDG PET/CT and CT/MRI with histopathologic correlation in patients undergoing central compartment neck dissection for squamous cell carcinoma of the larynx, hypopharynx, and esophagus.
abstract: OBJECTIVE
  Central compartment lymph node metastasis (CLNM) in patients with laryngeal, hypopharyngeal, or cervical esophageal squamous cell carcinoma is associated with unfavorable clinical outcomes, but cannot be reliably detected using computed tomography (CT)/magnetic resonance imaging (MRI). Therefore, we assessed the clinical utility of using (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT to identify CLNM in these patients.
  
  
  METHODS
  A total of 62 patients were preoperatively evaluated using (18)F-FDG PET/CT and CT/MRI. Histopathologic analysis of the dissected neck tissues was used as the gold standard for assessing these imaging techniques. The diagnostic value of (18)F-FDG PET/CT for detecting CLNM was calculated and compared with CT/MRI. Univariate and multivariate analyses were utilized to determine the factors predictive of CLNM.
  
  
  RESULTS
  Of the 62 patients in the study cohort, 12 (19%) had CLNM. Compared with histology, both (18)F-FDG PET/CT and CT/MRI demonstrated low sensitivity for detecting CLNM (58% vs 42%, respectively, P = 0.625). The specificities of (18)F-FDG PET/CT and CT/MRI for the detection of CLNM were 88% and 90%, respectively (P = 1.000). Univariate and multivariate analyses showed that clinical metastasis to any cervical lymph node was significantly associated with CLNM (P = 0.018).
  
  
  CONCLUSIONS
  Neither (18)F-FDG PET/CT nor CT/MRI is a sensitive diagnostic imaging modality for detecting CLNM. Routine elective central compartment dissection or radiotherapy should be advocated for the treatment of these patients.
authors: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Republic of Korea.
authors: Ji Won
authors: JW
authors: Kim
authors: Jong-Lyel
authors: JL
authors: Roh
authors: Jae Seung
authors: JS
authors: Kim
authors: Jeong Hyun
authors: JH
authors: Lee
authors: Kyung-Ja
authors: KJ
authors: Cho
authors: Seung-Ho
authors: SH
authors: Choi
authors: Soon Yuhl
authors: SY
authors: Nam
authors: Sang Yoon
authors: SY
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D015331:Cohort Studies; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods* / Q000706:statistics & numerical data; D037981:Neck Dissection; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18