Abstract
Aim
Our objective was to evaluate the diagnostic role of dual-phase fluor-18 fluorodeoxyglucose
(F-18 FDG) positron emission tomography–computed tomography (PET–CT) and planar lymphoscintigraphy
in patients with oral cavity cancer (OCC). We also investigated the combined impact
of F-18 FDG PET–CT and sentinel lymph node biopsy (SLNB) in decision making for patients
with OCC.
Methods
Sixteen patients (4 female, 12 male; age range, 29–81 years) were included in this
prospective study. F-18 FDG PET–CT [1 (early) and 2 h (delayed) after injection] and
planar lymphoscintigraphy (2 h before the surgery) were performed for all the patients before surgery. The sensitivity,
specificity, and negative and positive predictive values in F-18 FDG PET–CT for the
early and the delayed scans and tumor/liver uptake (T/L) in the lymph nodes were calculated.
Receiver operating characteristic curves were obtained for standardized uptake value
(SUV)max and T/L.
Results
Histopathological evaluations revealed that 5 patients had metastatic lymph nodes
(pN+) whereas 11 patients had benign lymph nodes (pN−). Out of 43 lymph nodes visualized as cN(+) in F-18 FDG PET–CT, 14 were pathologically positive for malignancy, whereas 29 were pathologically
benign. There was no statistical difference between the N(+) and N(−) patients in
terms of age, depth of primary tumor, and the number of mitoses. However, there was
a significant difference between the N(+) and N(−) patients (P=.011) in terms of early and delayed F-18 FDG uptake of primary tumors. There was a
statistically significant difference in the value of SUVmax between the early and
the delayed scans for the malignant lymph nodes (P=.00).
Conclusion
This study indicates that F-18 FDG PET–CT is a reliable method for the correct evaluation of primary tumor and N staging
in OCCs. Delayed phase of F-18 FDG imaging may increase primary lesion detectability
due to higher FDG uptake in primary tumors compared to the early phase of imaging.
F-18 FDG PET–CT might demonstrate skip metastasis in lymph nodes which can be missed with SLNB.
Although SUV values increased in the delayed phase of F-18 PET–CT imaging in detecting lymph node metastases, the specificity and positive predictive
value did not increase.
Keywords
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Article info
Publication history
Published online: February 11, 2015
Accepted:
February 6,
2015
Received in revised form:
February 3,
2015
Received:
July 21,
2014
Footnotes
☆Conflict of interest: The authors stated that they have no potential conflicts of interest, including any financial support.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
