Document Detail

Incidental head and neck (18)F-FDG uptake on PET/CT without corresponding morphological lesion: early predictor of cancer development?
MedLine Citation:
PMID:  19305995     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To retrospectively determine whether increased/asymmetric FDG uptake on PET without a correlating morphological lesion on fully diagnostic CT indicates the development of a head and neck malignancy. METHODS: In 590 patients (mean age 55.4 +/- 13.3 years) without a head and neck malignancy/inflammation FDG uptake was measured at (a) Waldeyer's ring, (b) the oral floor, (c) the larynx, and (d) the thyroid gland, and rated as absent (group A), present (group B), symmetric (group B1) or asymmetric (group B2). Differences between groups A and B and between B1 and B2 were tested for significance with the U-test (p < 0.05). An average follow-up of about 2.5 years (mean 29.5 +/- 13.9 months) served as the reference period to determine whether patients developed a head and neck malignancy. RESULTS: Of the 590 patients, 235 (40%) showed no evidence of enhanced FDG uptake in any investigated site, and 355 (60%) showed qualitatively elevated FDG uptake in at least one site. FDG uptake values (SUV(max), mean+/-SD) for Waldeyer's ring were 3.0 +/- 0.89 in group A (n = 326), 4.5 +/- 2.18 in group B (n = 264; p < 0.01), 5.4 +/- 3.35 in group B1 (n = 177), and 4.1 +/- 1.7 in group B2 (n = 87; p < 0.01). Values for the oral floor were 2.8 +/- 0.74 in group A (n = 362), 4.7 +/- 2.55 in group B (n = 228; p < 0.01), 4.4 +/- 3.39 in group B1 (n = 130), and 5.1 +/- 2.69 in group B2 (n = 98, p = 0.01). Values for the larynx were 2.8 +/- 0.76 in group A (n = 353), 4.2 +/- 2.05 in group B (n = 237; p < 0.01), 4.0 +/- 2.02 in group B1 (n = 165), and 4.6 +/- 2.8 in group B2 (n = 72; p = 0.027). Values for the thyroid were 2.4 +/- 0.63 in group A (n = 404), 3.0 +/- 1.01 in group B (n = 186; p < 0.01), 2.6 +/- 0.39 in group B1 (n = 130), and 4.0 +/- 1.24 in group B2 (n = 56; p < 0.01). One patient developed a palatine tonsil carcinoma (group B1, SUV(max) 3.2), and one patient developed an oral floor carcinoma (group B1, SUV(max) 3.7). CONCLUSION: Elevated/asymmetric head and neck FDG accumulation without a correlating morphological lesion can frequently be found and does not predict cancer development. In populations in which goitre is endemic, FDG uptake by the thyroid is common and not associated with thyroid cancer.
Till A Heusner; Steffen Hahn; Monia E Hamami; Svenja K??gel; Michael Forsting; Andreas Bockisch; Gerald Antoch; Alexander R Stahl
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Publication Detail:
Type:  Journal Article     Date:  2009-03-21
Journal Detail:
Title:  European journal of nuclear medicine and molecular imaging     Volume:  36     ISSN:  1619-7089     ISO Abbreviation:  Eur. J. Nucl. Med. Mol. Imaging     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-11     Completed Date:  2010-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101140988     Medline TA:  Eur J Nucl Med Mol Imaging     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1397-406     Citation Subset:  IM    
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45122, Essen, Germany.
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MeSH Terms
Adenoids / metabolism,  radiography,  radionuclide imaging
Aged, 80 and over
Early Detection of Cancer*
Fluorodeoxyglucose F18 / diagnostic use*,  pharmacokinetics
Head and Neck Neoplasms / radiography,  radionuclide imaging*,  secondary
Larynx / metabolism,  radiography,  radionuclide imaging
Middle Aged
Mouth / metabolism,  radiography,  radionuclide imaging
Palatine Tonsil / metabolism,  radiography,  radionuclide imaging
Radiopharmaceuticals / diagnostic use*,  pharmacokinetics
Retrospective Studies
Thyroid Gland / metabolism,  radiography,  radionuclide imaging
Tomography, X-Ray Computed
Young Adult
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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