Document Detail


18F-Fluorodeoxyglucose-PET/CT to evaluate tumor, nodal disease, and gross tumor volume of oropharyngeal and oral cavity cancer: comparison with MR imaging and validation with surgical specimen.
MedLine Citation:
PMID:  19727695     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The purpose of this paper is to evaluate the impact of adding combined 18F-PET/CT to MRI for T and N staging of the oral and oropharyngeal cancer and calculation of the gross tumor volume (GTV) having histopathology as reference standard. METHODS: PET/CT and MRI were performed in 66 patients with suspected oral and oropharyngeal cancer (41 primary tumors/25 recurrent tumors) and nodal disease (114 nodes). Statistical analysis included the McNemar test, sensitivity, specificity for the diagnostic modalities as well as regression analysis, and Bland-Altman graphs for calculated tumor volumes. RESULTS: There was no statistically significant difference between the two modalities compared to pathological findings regarding detection of disease (P > or =0.72). The sensitivity/specificity for tumor detection were 100/80% and 96.72/60% for MRI and PET/CT, respectively. The sensitivity/specificity for nodal metastases were 88.46/75% and 83.81/73.91% for MRI and PET/CT, respectively. In 18% of cases, the MRI-based T staging resulted in an overestimation of the pathologic tumor stage. The corresponding rate for PET/CT was 22%. Regarding the treated necks, both modalities showed 100% sensitivity for detection of the recurrent lesions. In necks with histologically N0 staging, MRI and PET/CT gave 22% and 26% false positive findings, respectively. The mean tumor volume in the pathologic specimen was 16.6 +/- 18.6 ml, the mean volume derived by the MR imaging was 17.6 +/- 19.1 ml while the estimated by PET/CT volume was 18.8 +/- 18.1 ml (P < or =0.007 between the three methods). The Bland-Altman analysis showed a better agreement between PET/CT and MRI. CONCLUSION: The diagnostic performance of FDG-PET/CT in the local staging of oral cancer is not superior to MRI.
Authors:
Oliver Seitz; Nicole Chambron-Pinho; Markus Middendorp; Rober Sader; Martin Mack; Thomas J Vogl; Sotirios Bisdas
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Publication Detail:
Type:  Comparative Study; Journal Article; Validation Studies    
Journal Detail:
Title:  Neuroradiology     Volume:  51     ISSN:  1432-1920     ISO Abbreviation:  Neuroradiology     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-17     Completed Date:  2009-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1302751     Medline TA:  Neuroradiology     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  677-86     Citation Subset:  IM    
Affiliation:
Department of Oromaxillofacial Surgery, JW Goethe University, Frankfurt, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Lymph Nodes / pathology,  radiography,  radionuclide imaging
Lymphatic Metastasis / diagnosis,  pathology
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Mouth Neoplasms / diagnosis*,  pathology,  therapy
Neoplasm Recurrence, Local / diagnosis,  pathology
Neoplasm Staging
Oropharyngeal Neoplasms / diagnosis*,  pathology,  therapy
Positron-Emission Tomography / methods*
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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