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Evaluation of positron emission tomography imaging to detect lymph node metastases in patients with high‐risk cutaneous squamous cell carcinoma
Author(s) -
Fujiwara Masao,
Suzuki Takahiro,
Takiguchi Tetsuya,
Fukamizu Hidekazu,
Tokura Yoshiki
Publication year - 2016
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.13403
Subject(s) - medicine , positron emission tomography , micrometastasis , standardized uptake value , biopsy , malignancy , pathology , metastasis , fluorodeoxyglucose , lymph node , carcinoma , lymph , radiology , nuclear medicine , cancer
Abstract Ten to twenty percent of high‐risk cutaneous squamous cell carcinoma (cSCC) can metastasize to regional lymph nodes. Detection of nodal metastasis is mandatory to manage high‐risk cSCC. This study was aimed to evaluate the 18 F‐fluorodeoxyglucose positron emission tomography (FDG‐PET) imaging to assess lymph node (LN) metastasis of high‐risk cSCC patients. Twenty‐six patients with histologically proven primary cSCC were enrolled. All patients underwent whole‐body PET prior to lymphoscintigraphy and subsequent sentinel LN biopsy. The maximum standardized uptake value (SUVmax) of more than 2.5 is generally evaluated as a positive PET finding indicative of malignancy. On the basis of the histopathological and PET findings, 30 LN from 26 patients were categorized into four groups: (i) histologically negative and PET negative (true‐negative; n = 22); (ii) histologically positive and PET negative (false‐negative; n = 0); (iii) histologically positive and PET positive (true‐positive; n = 3); and (iv) histologically negative and PET positive (false‐positive; n = 5). The mean SUVmax was significantly higher in the true‐positive cases (11.0 ± 2.8) than in the false‐positive cases (3.4 ± 0.6). In the false‐positive cases, the number of tumor‐infiltrating inflammatory cells at the primary skin site was highest among the four groups, suggesting that inflammation contributed to the false‐positive uptake of FDG. Although we cannot negate the possibility of the presence of PET‐undetectable micrometastasis, the SUVmax value may be useful for avoidance of excess performance of sentinel LN biopsy.