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18 F‐FDG‐PET/CT for the Assessment of the Contralateral Neck in Patients with Head and Neck Squamous Cell Carcinoma
Author(s) -
Kastrinidis Nikos,
Kuhn Felix P.,
Hany Thomas F.,
Ahmad Nader,
Huber Gerhard F.,
Haerle Stephan K.
Publication year - 2013
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.23944
Subject(s) - medicine , standardized uptake value , positron emission tomography , head and neck squamous cell carcinoma , nuclear medicine , lymph node , metastasis , radiology , pet ct , head and neck cancer , pathology , cancer , radiation therapy
Objectives/Hypothesis The aim was to compare the value of 18‐Fluoro‐Deoxyglucose (18F‐FDG) positron emission tomography ( PET )/computed tomography ( CT ) regarding contralateral lymph node ( LN ) metastasis in the neck. Study Design Retrospective analysis of 61 patients staged by 18 F‐FDG‐PET/CT . Methods Cytology/histology served as a reference standard. Further, metabolic midline invasion ( MI ) of the primary tumor and the presence of bilateral LN metastases were assessed. Results A true positive rate in the ipsilateral neck of 80% versus 65% in the contralateral neck was found ( P = 0.067). Median‐standardized uptake value ( SUV )‐max for suspicious LN ipsilaterally was 7.6 versus 5.8 contralaterally ( P = 0.038). There was no positive correlation between metabolic MI and bilateral metastasis ( P = 0.82). Conclusions The rate of true positive detected LN by 18 F‐FDG‐PET/CT is less on the contralateral neck side; therefore, all suspicious LNs should be verified by cytology. A high SUV in the contralateral neck suggests metastatic disease regardless of nodal size. Metabolic MI needs to be addressed carefully as it was not predictive for bilateral LN involvement. Level of Evidence 4.