Clinical significance of SUVmax in (18)F-FDG PET/CT scan for detecting nodal metastases in patients with oral squamous cell carcinoma.
Clinical significance of SUVmax in (18)F-FDG PET/CT scan for detecting nodal metastases in patients with oral squamous cell carcinoma.
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DOI：
10.1186/s40064-015-1521-6
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Sugimura K
中科院分区：
文献类型：
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作者：
Kitajima K;Suenaga Y;Minamikawa T;Komori T;Otsuki N;Nibu K;Sasaki R;Itoh T;Sugimura K
目的探讨FDG-PET/CT对口腔鳞状细胞癌(OSCC)颈淋巴结转移的诊断价值。36例口腔鳞癌患者在FDG-PET/CT后行颈淋巴清扫术(4例双侧，32例单侧，250个结节节段)。两名观察者协商一致地确定了可见颈部结节的病变大小和SUVmax，并将结果与结节水平的病理结果进行了比较。组织病理学显示36例患者中有13例(36.1%)有结节转移，250个结节平面中有28例(11.2%)有转移。以最佳判别阈值SUVmax为3.5，FDG-PET/CT诊断淋巴结转移的敏感性、特异性和准确性分别为67.9%、94.6%和91.6%。CT的相应数字分别为42.9、96.8和90.8%。FDGPET/CT的敏感性明显优于CT(p<0.023)。此外，以水平为基础的改良SUVmax截断法，FDGPET/CT分别为71.4%、95.9%和93.2%，其敏感性(p=0.013)和准确性(p=0.041)均显著高于CT。FDGPET/CT结合SUVmax是评估口腔鳞癌患者颈淋巴转移的一种有用的方法。
To retrospectively investigate the diagnostic accuracy of FDG-PET/CT relative to CT for detection of cervical node metastases in patients with oral squamous cell carcinoma (OSCC), using histologic evaluation of dissected cervical nodes as the reference standard. Thirty-six patients with OSCC who underwent neck dissection (4 bilateral, 32 unilateral; 250 nodal levels) after FDG-PET/CT. Two observers consensually determined the lesion size and SUVmax of visible cervical nodes and compared the results with pathologic findings at the nodal level. Histopathology revealed nodal metastases in 13 (36.1 %) of 36 patients and 28 (11.2 %) of 250 nodal levels. Using a best discriminative SUVmax cut-off of 3.5 for the node, the sensitivity, specificity and accuracy of FDG-PET/CT for identification of nodal metastases on a level-by-level basis were 67.9, 94.6, and 91.6 %, respectively. The corresponding figures for CT were 42.9, 96.8, and 90.8 %, respectively. The sensitivity of FDG-PET/CT was significantly better than CT (p = 0.023). Moreover, using the level-based modified SUVmax cut-off, the respective figures for FDG-PET/CT were 71.4, 95.9, and 93.2 %, with significantly higher sensitivity (p = 0.013) and accuracy (p = 0.041) than CT. FDG PET/CT with SUVmax is a useful modality for preoperative evaluation of cervical neck lymph node metastases in patients with OSCC.