Prospective study of 18FDG-PET in the detection and management of patients with lymph node metastases to the neck from an unknown primary tumor. Results from the DAHANCA-13 study
Prospective study of 18FDG-PET in the detection and management of patients with lymph node metastases to the neck from an unknown primary tumor. Results from the DAHANCA-13 study
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DOI：
10.1002/hed.20734
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发表时间：
2008-04-01
影响因子：
2.9
通讯作者：
Overgaard, Jens
中科院分区：
文献类型：
--
作者：
Johansen, Jorgen;Buus, Simon;Overgaard, Jens
背景前瞻性研究了补充性氟脱氧葡萄糖-正电子发射断层扫描（FDG-PET）扫描对原发性不明癌（CUP）和转移性颈部病变的标准检查的益处。根据国家指南，67例患者接受了标准化诊断检查，包括全内镜检查、多处粘膜活检和诊断性CT/MRI扫描。中位随访时间为40个月（范围，2-65个月）。在60例符合条件的患者中，FDG-PET显示30例患者（50%）存在原发性肿瘤或转移性疾病。其他检查证实了18例患者的原发性肿瘤：下咽部5例，口咽部5例，鼻咽部2例，肺1例，腋窝1例，骨1例，直肠1例，以及2例患者的CUP多发性转移灶。回顾过去，MRI能够检测到1个PET检测到的原发灶，导致CUP中PET的总体检出率为29%。由于FDG-PET，25%的患者进行了治疗改变。结论：内镜前PET检查可减少假阳性病灶。FDG-PET是一种有价值的工具，除了传统的广泛的后处理，在CUP和颈部转移。因此，FDG-PET现在被推荐为这些患者的早期诊断方法。(C)2007 Wiley Periodicals，Inc.
Background. The benefit of a complementary fluorodeoxyglucose-positron emission tomography (FDG-PET) scan to standard workup for carcinoma of unknown primary (CUP) and metastatic neck lesions was prospectively studied.Methods. Sixty-seven patients underwent standardized diagnostic workup according to national guidelines including panendoscopies, multiple mucosal biopsies, and diagnostic CT/MRI scans. Median follow-up was 40 months (range, 2-65 months).Results. In 60 eligible patients, FDG-PET indicated a primary tumor or metastatic disease in 30 patients (50%). Additional investigations confirmed a primary tumor in 18 patients: hypopharynx in 5, oropharynx in 5, nasopharynx in 2, lung in 1, axilla in 1, bone in 1, rectum in 1, as well as multiple metastatic lesions from CUP in 2 patients. In retrospect, MRI was able to detect 1 of the PET-detected primaries, leading to an overall detection rate of PET of 29% in CUP. A therapeutic change of treatment was made in 25% as a consequence of FDG-PET. PET before panendoscopy demonstrated fewer false-positive pathological foci.Conclusion. FDG-PET is a valuable tool in addition to conventional extensive workup in CUP and neck metastases. Consequently, FDG-PET is now recommended as an early diagnostic modality in the workup of these patients. (C) 2007 Wiley Periodicals, Inc.