title: [(18)F]-FDG PET/CT imaging for detection of nodal metastases in patients with squamous cell carcinoma of the pharynx and larynx: comparison with CT.
abstract: OBJECTIVE
  Our aim was to investigate the diagnostic accuracy of fluorine-18-labeled fluorodeoxyglucose positron emission tomography computed tomography (FDG-PET/CT) relative to CT for detecting neck lymph node metastases in patients with squamous cell carcinoma (SCC) of the hypopharynx, oropharynx, and larynx.
  
  
  METHODS
  Thirty-four patients with SCC of the hypopharynx (n = 20), oropharynx (n = 5), and larynx (n = 9) who underwent neck dissection (29 bilateral, 5 unilateral; a total of 355 nodal levels) were assessed. Two observers determined the long-axis diameter and maximum standardized uptake value (SUVmax) of all visible neck nodes. Results of FDG-PET/CT were compared with those of corresponding histopathologic examinations according to the neck-level system.
  
  
  RESULTS
  Histopathology revealed metastases in 70 of 355 nodal levels. Using a best discriminative SUVmax cutoff of 3.65, sensitivity, specificity, and accuracy of FDG-PET/CT on a level-by-level basis were 72.9, 96.8, and 92.1 %; those for CT were 52.9, 98.6, and 89.6 %. Differences in sensitivity and accuracy were significant (p < 0.01). The best cutoff SUVmax on the ipsilateral side was 4.61, with corresponding figures of 81.6, 100, and 94.7 %; that on the contralateral side was 2.41, with figures of 60, 88.4, and 85.4 %.
  
  
  CONCLUSIONS
  FDG-PET/CT with SUVmax is useful for preoperative evaluation of neck-node metastasis from SCC of the pharynx and larynx, especially on the ipsilateral side.
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Suenaga
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. kitajima@med.kobe-u.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kitajima
authors.affiliation: Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Kanda
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Otsuki
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Nibu
authors.affiliation: Department of Radiology, Division of Radiation Oncology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Sasaki
authors.affiliation: Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Itoh
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology*; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging*; D010610:Pharyngeal Neoplasms / Q000473:pathology*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG; HNSCC (head and neck squamous cell carcinoma); Lymph node metastasis; PET/CT