18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in the Assessment of Occult Primary Head and Neck Cancers 鈥?An Audit and Review of Published Studies

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• 作者：W.L. Wong^&lowast ; ; ^{wailupwong@gmail.com} ; L.I. Sonoda^&lowast ; ; A. Gharpurhy^&lowast ; ; F. Gollub^&lowast ; ; D. Wellsted^&dagger ; ; K. Goodchild^&Dagger ; ; C. Lemon^&Dagger ; ; R. Farrell^§ ; ; M. Saunders^&Dagger ; ; ^||
• 关键词：FDG ; head and neck cancer ; neck cancer ; neck nodes ; occult primary cancer ; PET ; PET/CT
• 刊名：Clinical Oncology
• 出版年：2012
• 期刊代码：281_09366555
• 类别：med
• 出版时间：April, 2012
• 卷：24
• 期：3
• 页码：190-195
• 文件大小：129 K

摘要

Aims

To assess the value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with squamous cell and undifferentiated cancer neck nodes and no primary site on conventional assessment.

Materials and methods

Seventy-eight patients with neck nodal metastases from an unknown primary cancer were studied. PET/CT was carried out in all patients, 1 h after FDG injection.

Results

Uptake suspicious of an occult primary cancer was found in 46/78 (59.0%) patients. Subsequent investigations confirmed a primary site in the base of the tongue in 14, pharyngeal palatine tonsil in 14, post cricoid in one, lung in one. PET/CT diagnosed primary cancers in 30/78 patients (38.5%); sensitivity, specificity, positive predictive value, negative predictive value: 30/30 (100.0%), 32/48 (66.7%), 30/46 (65.2%), 32/32 (100.0%), respectively. PET/CT detected additional disease in four patients: contralateral nodal disease in two, mediastinal nodal disease in one and liver metastases in one.

Conclusions

FDG PET/CT is of value in the assessment of patients with occult head and neck primary cancers. However, false-positive results remain a limitation of the investigation.