title: FDG PET/MR for lymph node staging in head and neck cancer.
abstract: OBJECTIVE
  To assess the diagnostic value of PET/MR (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for lymph node staging in head and neck cancer.
  
  
  METHODS
  This prospective study was approved by the local ethics committee; all patients signed informed consent. Thirty-eight patients with squamous cell carcinoma of the head and neck region underwent a PET scan on a conventional scanner and a subsequent PET/MR on a whole-body hybrid system after a single intravenous injection of FDG. The accuracy of PET, MR and PET/MR for lymph node metastases were compared using receiver operating characteristic (ROC) analysis. Histology served as the reference standard.
  
  
  RESULTS
  Metastatic disease was confirmed in 16 (42.1%) of 38 patients and 38 (9.7%) of 391 dissected lymph node levels. There were no significant differences between PET/MR, MR and PET and MR (p>0.05) regarding accuracy for cervical metastatic disease. Based on lymph node levels, sensitivity and specificity for metastatic involvement were 65.8% and 97.2% for MR, 86.8% and 97.0% for PET and 89.5% and 95.2% for PET/MR.
  
  
  CONCLUSIONS
  In head and neck cancer, FDG PET/MR does not significantly improve accuracy for cervical lymph node metastases in comparison to MR or PET.
authors.affiliation: Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden, Germany. Electronic address: ivan.platzek@uniklinikum-dresden.de.
authors.forename: Ivan
authors.initials: I
authors.lastname: Platzek
authors.affiliation: Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden, Germany. Electronic address: bettina.beuthien-baumann3@uniklinikum-dresden.de.
authors.forename: Bettina
authors.initials: B
authors.lastname: Beuthien-Baumann
authors.affiliation: Dresden University Hospital, Department of Oral and Maxillofacial Surgery, Fetscherstr. 74, 01307 Dresden, Germany. Electronic address: m.schneider@mkgdresden.de.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
authors.affiliation: Dresden University Hospital, Department of Otolaryngology, Fetscherstr. 74, 01307 Dresden, Germany. Electronic address: volker.gudziol@uniklinikum-dresden.de.
authors.forename: Volker
authors.initials: V
authors.lastname: Gudziol
authors.affiliation: Dresden University Hospital, Department of Neuroradiology, Fetscherstr. 74, 01307 Dresden, Germany. Electronic address: hagen.kitzler@uniklinikum-dresden.de.
authors.forename: Hagen H
authors.initials: HH
authors.lastname: Kitzler
authors.affiliation: Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden, Germany. Electronic address: j.maus@hzdr.de.
authors.forename: Jens
authors.initials: J
authors.lastname: Maus
authors.affiliation: Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden, Germany. Electronic address: g.schramm@hzdr.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Schramm
authors.affiliation: Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden, Germany. Electronic address: manuel.popp@praxisklinik-dresden.de.
authors.forename: Manuel
authors.initials: M
authors.lastname: Popp
authors.affiliation: Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden, Germany. Electronic address: michael.laniado@uniklinikum-dresden.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Laniado
authors.affiliation: Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden, Germany. Electronic address: Joerg.Kotzerke@uniklinikum-dresden.de.
authors.forename: Jörg
authors.initials: J
authors.lastname: Kotzerke
authors.affiliation: Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden, Germany. Electronic address: j.van_den_hoff@hzdr.de.
authors.forename: Jörg
authors.initials: J
authors.lastname: van den Hoff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000556:secondary*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology*; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Head and neck cancer; Lymph node metastasis; PET/MR; Staging