title: Extracapsular spread in hypopharyngeal squamous cell carcinoma: diagnostic value of FDG PET/CT.
abstract: BACKGROUND
  The purpose of this study was to evaluate the use of fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT for the identification of extracapsular spread (ECS) with supporting histologic correlation in hypopharyngeal cancer.
  
  
  METHODS
  We retrospectively reviewed the medical records of 57 patients who underwent FDG PET/CT for hypopharyngeal cancer.
  
  
  RESULTS
  ECS was present in 79% dissected necks (45 of 57 patients) and in 64% dissected cervical levels (55 of 86). A significant difference in standardized uptake value maximum (SUVmax ) values was found between cervical lymph nodes with and without ECS (6.10 ± 3.51 vs 1.75 ± 1.46, respectively; p < .001). The cutoff value of SUVmax for differentiating with and without ECS was 2.65 with a sensitivity of 80% and a specificity of 74%. The presence of ECS and median SUVmax were found to have a significant adverse effect on 5-year disease-specific survival.
  
  
  CONCLUSIONS
  Median FDG PET/CT SUVmax cutoff values of 2.65 or greater are associated with a greater risk of ECS in cervical lymph node metastasis from hypopharyngeal squamous cell carcinoma (SCC).
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Joo
authors.forename: Ie-Ryung
authors.initials: IeR
authors.lastname: Yoo
authors.forename: Kwang-Jae
authors.initials: KJ
authors.lastname: Cho
authors.forename: Jun-Ook
authors.initials: JO
authors.lastname: Park
authors.forename: In-Chul
authors.initials: IC
authors.lastname: Nam
authors.forename: Min-Sik
authors.initials: MS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: hypopharynx; lymphatic metastasis; positron-emission tomography; squamous cell carcinoma