title: The added value of 18F-fluorodeoxyglucose positron emission tomography computed tomography in patients with neck lymph node metastases from an unknown primary malignancy.
abstract: BACKGROUND
  The search for a primary malignancy in patients with a metastatic cervical lymph node is challenging yet ultimately of utmost clinical importance. This study evaluated the efficacy of positron emission tomography computed tomography in detecting the occult primary, within the context of a tertiary referral centre head and neck cancer multidisciplinary team tumour board meeting.
  
  
  METHODS
  Thirty-two patients (23 men and 9 women; mean and median age, 61 years) with a metastatic cervical lymph node of unknown primary origin, after clinical examination and magnetic resonance imaging, underwent positron emission tomography computed tomography.
  
  
  RESULTS
  The primary tumour detection rate was 50 per cent (16/32). Positron emission tomography computed tomography had a sensitivity of 94 per cent (16/17) and a specificity of 67 per cent (10/15). Combining these results with those of 10 earlier studies of similar patients gave an overall detection rate of 37 per cent.
  
  
  CONCLUSIONS
  Positron emission tomography computed tomography has become an important imaging modality. To date, it has the highest primary tumour detection rate, for head and neck cancer patients presenting with cervical lymph node metastases from an unknown primary.
authors.affiliation: Department of Radiology, University Hospital Aintree, Liverpool, UK. sjbprowse@gmail.com
authors.forename: S J B
authors.initials: SJ
authors.lastname: Prowse
authors.forename: R
authors.initials: R
authors.lastname: Shaw
authors.forename: D
authors.initials: D
authors.lastname: Ganeshan
authors.forename: P M
authors.initials: PM
authors.lastname: Prowse
authors.forename: R
authors.initials: R
authors.lastname: Hanlon
authors.forename: H
authors.initials: H
authors.lastname: Lewis-Jones
authors.forename: H
authors.initials: H
authors.lastname: Wieshmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18