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Utility of quantitative 18 F ‐fluorodeoxyglucose uptake measurement to identify occult tonsillar carcinoma in patients with cervical metastasis of unknown primary tumours: a retrospective case–control study
Author(s) -
Lee H.J.,
Kim J.S.,
Roh J.L.,
Lee J.H.,
Cho K.J.,
Park G.C.,
Choi S.H.,
Nam S.Y.,
Kim S.Y.
Publication year - 2013
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.12055
Subject(s) - medicine , fluorodeoxyglucose , occult , positron emission tomography , metastasis , carcinoma , stage (stratigraphy) , retrospective cohort study , cervical lymph nodes , standardized uptake value , radiology , nuclear medicine , cancer , pathology , paleontology , alternative medicine , biology
Objectives Due to relatively high 18 F ‐fluorodeoxyglucose accumulation in the tonsillar region, the detection of occult tonsillar cancers by 18 F ‐fluorodeoxyglucose positron emission tomography/computerised tomography remains controversial. Therefore, we assessed the usefulness of quantitative tonsil 18 F ‐fluorodeoxyglucose uptake in identifying occult tonsillar squamous cell carcinoma. Design A case–control study of retrospective cohorts. Setting University T eaching H ospital. Main outcome measures We assessed all patients diagnosed with tonsillar cancers or cervical lymph node metastasis of unknown primary tumours between 2005 and 2010 who underwent 18 F ‐fluorodeoxyglucose positron emission tomography/computerised tomography. The subjects were grouped into A (apparent early pT ‐stage tonsillar squamous cell carcinoma; n = 27), B (occult tonsillar squamous cell carcinoma, primary tumours were found by surgery; n = 21), C (cervical metastasis of unknown primary tumour, primary tumours were not found by surgery and for follow‐up; n = 16) and D (33 healthy controls). Tonsillar maximum standardised uptake values were bilaterally measured and compared between groups. Results The sensitivity and specificity of qualitative assessment of 18 F ‐fluorodeoxyglucose positron emission tomography/computerised tomography for detection of occult tonsillar cancers were 67% and 69%, respectively. Mean maximum standardised uptake values of tonsils with cancer were 11.19 ± 5.46 in group A and 8.12 ± 4.52 in group B , which were significantly higher than that of group C (4.62 ± 1.76) or group D (4.57 ± 1.62) ( P < 0.01). The mean maximum standardised uptake value differences of groups A (6.35) and B (3.11) were significantly greater than those of groups C (0.32) and D (0.59) ( P < 0.01). Similarly, the mean maximum standardised uptake value ratios of groups A (2.47) and B (1.73) were significantly greater than those of groups C (1.06) and D (1.16) ( P < 0.01). Conclusion 18 F‐fluorodeoxyglucose positron emission tomography/computerised tomography with tonsil SUV max measurement is useful to identify occult tonsillar squamous cell carcinoma.