title: 18F-FDG PET-CT as a supplement to CT/MRI for detection of nodal metastasis in hypopharyngeal SCC with palpably negative neck.
abstract: OBJECTIVE
  To determine the diagnostic value of (18) F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) compared with CT or magnetic resonance (MR) imaging for the detection of nodal metastasis in patients with hypopharyngeal squamous cell carcinoma (SCC) with palpably negative neck and to assess the role of PET-CT as a supplement to CT/MR.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  A total of 39 patients with palpably negative neck (36 men and 3 women; average age 65.4 years) underwent tumor resection and neck dissection as primary treatment. All patients were preoperatively evaluated with PET-CT and CT and/or MR, and imaging data were retrospectively reviewed. The diagnostic performance of PET-CT, CT/MR, and a combination of PET-CT and CT/MR was assessed using histopathologic results as a gold standard.
  
  
  RESULTS
  Twenty (51.3%) of the 39 patients were found to have neck metastases. On a level-based analysis, the sensitivity of PET-CT, CT/MR, and combined interpretation of PET-CT and CT/MR was 65.7%, 57.1%, and 65.7%, respectively, but without statistical significance. Of the six patients who showed false negative neck findings based on CT/MR in addition to palpation, four cases were still missed with additional PET-CT.
  
  
  CONCLUSIONS
  The addition of PET-CT examination to anatomic imaging involving CT and MR did not provide additional benefit for the preoperative evaluation of cervical nodal metastasis in patients with hypopharyngeal SCC with nonpalpable neck, yielding insufficient data to spare elective neck dissection.
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Ho-Joon
authors: HJ
authors: Lee
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Jinna
authors: J
authors: Kim
authors: Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Ha Young
authors: HY
authors: Woo
authors: Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Won Jun
authors: WJ
authors: Kang
authors: Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Jae-Hoon
authors: JH
authors: Lee
authors: Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Yoon Woo
authors: YW
authors: Koh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009333:Neck; D010173:Palpation; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: PET-CT, CT, MR; hypopharynx; squamous cell carcinoma