title: FDG uptake in cervical lymph nodes in children without head and neck cancer.
abstract: Reactive cervical lymphadenopathy is common in children and may demonstrate increased18F-fluoro-deoxyglucose (18F-FDG) uptake on positron emission tomography/computed tomography (PET/CT).
  
  
  
  We sought to evaluate the frequency and significance of18F-FDG uptake by neck lymph nodes in children with no history of head and neck cancer.
  
  
  
  The charts of 244 patients (114 female, mean age: 10.4 years) with a variety of tumors such as lymphoma and post-transplant lymphoproliferative diseases (PTLD), but no head and neck cancers, who had undergone18F-FDG PET/CT were reviewed retrospectively. Using the maximum standardized uptake value (SUVmax), increased18F-FDG uptake by neck lymph nodes was recorded and compared with the final diagnosis based on follow-up studies or biopsy results.
  
  
  
  Neck lymph node uptake was identified in 70/244 (28.6%) of the patients. In 38 patients, the lymph nodes were benign. In eight patients, the lymph nodes were malignant (seven PTLD and one lymphoma). In 24 patients, we were not able to confirm the final diagnosis. Seven out of the eight malignant lymph nodes were positive for PTLD. The mean SUVmax was significantly higher in malignant lesions (4.2) compared with benign lesions (2.1) (P = 0.00049).
  
  
  
  18F-FDG uptake in neck lymph nodes is common in children and is frequently due to reactive lymph nodes, especially when the SUVmax is <3.2. The frequency of malignant cervical lymph nodes is higher in PTLD patients compared with other groups.
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada. reza.vali@sickkids.ca.
authors.forename: Reza
authors.initials: R
authors.lastname: Vali
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada.
authors.forename: Alaa
authors.initials: A
authors.lastname: Bakkari
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada.
authors.forename: Eman
authors.initials: E
authors.lastname: Marie
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Kousha
authors.affiliation: Brampton Nuclear Services, Toronto, ON, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Charron
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Ave., Toronto, ON, M5G 1X8, Canada.
authors.forename: Amer
authors.initials: A
authors.lastname: Shammas
mesh_terms: D001706:Biopsy; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D009333:Neck; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Children; Computed tomography; Lymph nodes; Neck; Positron emission tomography; Post-transplant lymphoproliferative diseases