Comparison of Positron Emission Tomography/Computed Tomography Imaging and Ultrasound in Staging and Surveillance of Head and Neck and Thyroid Cancer
Comparison of Positron Emission Tomography/Computed Tomography Imaging and Ultrasound in Staging and Surveillance of Head and Neck and Thyroid Cancer
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DOI：
10.1002/lary.20594
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发表时间：
2009-10-01
期刊：
影响因子：
2.6
通讯作者：
Orloff, Lisa A.
中科院分区：
文献类型：
--
作者：
Hwang, Harry S.;Perez, Daniel A.;Orloff, Lisa A.
目的/假设：正电子发射断层扫描（PET）结合横断面计算机断层扫描（CT）越来越多地用于头颈部癌症的分期和监测。超声检查（US）是一种替代成像技术，可提供诊断信息，同时实现图像引导活检。这些诊断模式在癌症detection.Methods比较：所有恶性肿瘤的患者在头部和颈部区域进行了评价PET/CT和US进行了审查。PET/CT和US的诊断准确率，根据是否细胞学或组织学证实的癌症是存在于US引导下细针穿刺活检或手术samples.Results：从2004年10月至2007年12月，42例最终确认组织诊断的头颈部恶性肿瘤进行了颈部US和PET/CT。超声诊断头颈部恶性肿瘤的敏感性和特异性分别为96.8%和93.3%。阳性预测值（PPV）为96%，阴性预测值（NPV）为93%。结论：PET/CT与超声，尤其是结合超声引导下细针穿刺活检，在头颈部肿瘤的诊断中具有互补性。超声的高度敏感性和特异性，结合其低成本、低发病率、作为办公室检查的可用性以及指导活检的能力，保证了其在头颈部和甲状腺癌患者管理中的常规使用。
Objectives/Hypothesis: Positron emission tomography (PET) combined with cross-sectional computed tomography (CT) is increasingly used for staging and surveillance of cancers in the head and neck region. Ultrasonography (US) is an alternative imaging technique that provides diagnostic information while enabling simultaneous image-guided biopsies. A comparison of these diagnostic modalities in cancer detection is warranted.Methods: All patients with malignant neoplasms in the head and neck region who were evaluated by both PET/CT and US were reviewed. Diagnostic accuracy rates of PET/CT and US were determined according to whether cytologically or histologically confirmed cancer was present in US-guided fine-needle biopsy or surgical specimens.Results: From October 2004 to December 2007, 42 patients with an ultimately confirmed tissue diagnosis of a head and neck malignancy underwent both neck US and PET/CT. The sensitivity and specificity of US in predicting malignancy in the head and neck was 96.8% and 93.3%, respectively, in those 42 individuals. The positive predictive value (PPV) was 96% and the negative predictive value (NPV) was 93%. In comparison, PET/CT in this group demonstrated a sensitivity of 90.3%, specificity 20%, PPV 70%, and NPV 50%.Conclusions: PET/CT and US, especially when combined with US-guided fine-needle biopsy, are complementary tools in the detection of cancers of the head and neck. The highly sensitive and specific nature of US, combined with its low cost, low morbidity, availability as an in-office examination, and ability to guide biopsies, warrant consideration of its routine use in the management of head and neck and thyroid cancer patients.