Impact of FDG-PET/CT imaging on nodal staging for head-and-neck squamous cell carcinoma
Impact of FDG-PET/CT imaging on nodal staging for head-and-neck squamous cell carcinoma
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DOI：
10.1016/j.ijrobp.2006.12.032
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发表时间：
2007-06-01
影响因子：
7
通讯作者：
Yamashita, Yasuyuki
中科院分区：
文献类型：
--
作者：
Murakami, Ryuji;Uozumi, Hideaki;Yamashita, Yasuyuki
目的：为了评估18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）成像对头颈部鳞状细胞癌（SCC）的淋巴结分期的影响，方法和材料：研究人群包括23例头颈部鳞状细胞癌患者进行了FDG-PET/CT评估，并进行了颈淋巴结清扫术。两名观察员一致确定病变大小和最大标准化摄取值（SUVmax），并将结果与病理结果进行比较。两个不同的观察者（A和B）独立地进行三个方案的临床淋巴结分期。方法1、2和3分别基于常规模式、FDG-PET/CT图像的附加视觉信息和单独的FDG-PET/CT成像与SUV数据。病理学上，19个阳性和93个阴性淋巴结水平被确定。SUVmax在直径< 15 mm的阴性和阳性结节中重叠。根据受试者操作特征分析，对于< 10 mm、10-15 mm和> 15 mm的淋巴结，基于大小的SUVmax截止值分别为1.9、2.5和3.0。这些临界值产生了79%的敏感性和99%的特异性的肿瘤分期。对于观察者A，方法1、2和3的灵敏度和特异性分别为68%和94%、68%和99%以及84%和99%，方法3的准确性显著高于方法1（p = 0.0269）。对于观察员B，方法3产生了最高的灵敏度（84%）和特异性（99%），然而，三个协议之间的差异是没有统计学意义的结论：成像FDG-PET/CT与大小为基础的SUVmax截止值是一个重要的方式放射治疗计划。(C)2007年爱思唯尔公司
Purpose: To evaluate the impact of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging on nodal staging for head-and-neck squamous cell carcinoma (SCC).Methods and Materials: The study population consisted of 23 patients with head-and-neck SCC who were evaluated with FDG-PET/CT and went on to neck dissection. Two observers consensually determined the lesion size and maximum standardized uptake value (SUVmax) and compared the results with pathologic findings on nodal-level involvement. Two different observers (A and B) independently performed three protocols for clinical nodal staging. Methods 1, 2, and 3 were based on conventional modalities, additional visual information from FDG-PET/CT images, and FDG-PET/CT imaging alone with SUV data, respectively.Results: All primary tumors were visualized with FDG-PET/CT. Pathologically, 19 positive and 93 negative nodal levels were identified. The SUVmax overlapped in negative and positive nodes < 15 mm in diameter. According to receiver operating characteristics analysis, the size-based SUVmax cutoff values were 1.9, 2.5, and 3.0 for lymph nodes < 10 mm, 10-15 mm, and > 15 mm, respectively. These cutoff values yielded 79% sensitivity and 99% specificity for nodal-level staging. For Observer A, the sensitivity and specificity in Methods 1, 2, and 3 were 68% and 94%, 68% and 99%, and 84% and 99%, respectively, and Method 3 yielded significantly higher accuracy than Method 1 (p = 0.0269). For Observer B, Method 3 yielded the highest sensitivity (84%) and specificity (99%); however, the difference among the three protocols was not statistically significant.Conclusion: Imaging with FDG-PET/CT with size-based SUVmax cutoff values is an important modality for radiation therapy planning. (C) 2007 Elsevier Inc.