CT, MR, US, 18F-FDG PET/CT, and their combined use for the assessment of cervical lymph node metastases in squamous cell carcinoma of the head and neck
CT, MR, US, 18F-FDG PET/CT, and their combined use for the assessment of cervical lymph node metastases in squamous cell carcinoma of the head and neck
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DOI：
10.1007/s00330-008-1192-6
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发表时间：
2009-03-01
影响因子：
5.9
通讯作者：
Lee, In Jae
中科院分区：
文献类型：
--
作者：
Yoon, Dae Young;Hwang, Hee Sung;Lee, In Jae
本回顾性研究的目的是比较四种不同的成像方法-计算机断层扫描（CT），磁共振（MR）成像，超声（US），和F-18-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/CT-的诊断价值和他们的联合使用术前检测颈部淋巴结转移的头颈部鳞状细胞癌（SCC）。67例头颈部SCC患者（58例男性和9例女性;平均年龄60.1岁）在术前接受了CT、MR、US和PET/CT检查。首先，分别审查每项研究是否存在淋巴结转移。然后，根据观察者分配的每种模态的置信度评分评估组合图像的价值。这些结果在逐层基础上与组织病理学结果进行了验证。组织学检查发现402个淋巴结中有74个淋巴结转移。CT和MR的敏感性、特异性和准确性分别为77.0%、99.4%和95.3%; US分别为78.4%、98.5%和94.8%; PET/CT分别为81.1%、98.2%和95.0%。三种检查方法比较，差异无统计学意义（p > 0.05）。CT、MR、US和PET/CT的组合提高了灵敏度（86.5%），而没有损失特异性（99.4%）和准确性（97.0%），尽管差异未能达到统计学显著性。
The purpose of this retrospective study was to compare the diagnostic value of four different imaging methods-computed tomography (CT), magnetic resonance (MR) imaging, ultrasonography (US), and F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT-and their combined use for preoperative detection of cervical nodal metastases in head and neck squamous cell carcinoma (SCC). Sixty-seven patients (58 men and 9 women; mean age, 60.1 years) with head and neck SCCs underwent CT, MR, US, and PET/CT before surgery. First, each study was reviewed separately for the presence of nodal metastases. Then, the value of combined images was assessed based on a confidence rating score for each modality assigned by observers. These results were verified, on a level-by-level basis, with histopathologic findings. Histopathologic examination revealed nodal metastases in 74 of 402 nodal levels. The sensitivity, specificity, and accuracy were 77.0%, 99.4%, and 95.3% for CT and MR; 78.4%, 98.5%, and 94.8% for US; and 81.1%, 98.2%, and 95.0% for PET/CT, respectively. The comparison of these modalities showed no statistically significant difference among them (p > 0.05). The combination of CT, MR, US, and PET/CT improved sensitivity (86.5%), without loss of specificity (99.4%) and accuracy (97.0%), although the difference failed to reach statistical significance.