| Staging primary head and neck cancers with (18)F-FDG PET/CT: is intravenous contrast administration really necessary? | |
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MedLine Citation:
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PMID: 19352652 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The aim of our study was to prospectively evaluate whether intravenous contrast media in integrated positron emission tomography and computed tomography (PET/CT) with (18)F-fluorodeoxyglucose ((18)F-FDG) significantly contributes to evaluation of primary head and neck cancers compared with unenhanced PET/CT, regional contrast-enhanced CT of head and neck (neck CE-CT) and regional magnetic resonance imaging of head and neck (neck MRI). METHODS: Subjects were 42 consecutive patients (35 men, 7 women; age range: 36-91 years) with biopsy-proven primary head and neck cancers. Lesion detection of primary and nodal sites and TNM classification were assessed on a per-patient basis. McNemar test and kappa statistics were employed for statistical analyses. RESULTS: Forty patients (95%) were successfully followed up: 24 patients had nodal disease and 3 had distant metastasis. Contrast-enhanced and unenhanced PET/CT detected 98 and 95% of the primary tumours, respectively, and both detected 92% of patients with nodal disease, which revealed no statistically significant difference. Accuracy for T status was 75 and 73%, respectively, which proved significantly more accurate than neck CE-CT, which had an accuracy of 53% (p = 0.0133 and 0.0233, respectively). Neck MRI correctly classified the T status in 58% of patients; however, no statistically significant difference was found between PET/CT and neck MRI. Contrast-enhanced PET/CT, unenhanced PET/CT, neck CT and neck MRI correctly staged the N status in 90, 90, 79 and 90% of patients, respectively, with no statistically significant difference. Overall TNM classification was correctly classified in 68 and 65% of patients, respectively. Weighted kappa values between enhanced and unenhanced PET/CT for primary tumour detection, nodal detection, T status and N status were 0.655, 1.000, 0.935 and 1.000, respectively. CONCLUSION: We found almost perfect correlation between enhanced and unenhanced PET/CT for lesion detection and initial staging of primary head and neck cancers. Routine contrast administration for PET/CT imaging may not be justified. |
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Authors:
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Keisuke Yoshida; Akiko Suzuki; Toshiyuki Nagashima; Jin Lee; Choichi Horiuchi; Mamoru Tsukuda; Tomio Inoue |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-04-08 |
Journal Detail:
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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:
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Created Date: 2009-08-11 Completed Date: 2010-02-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101140988 Medline TA: Eur J Nucl Med Mol Imaging Country: Germany |
Other Details:
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Languages: eng Pagination: 1417-24 Citation Subset: IM |
Affiliation:
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Department of Radiology, Yokohama City University, 3-9 Fukuura, Yokohama, Japan. kei-yoshida@nyc.odn.ne.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Contrast Media / administration & dosage, diagnostic use* Female Fluorodeoxyglucose F18 / diagnostic use* Head and Neck Neoplasms / pathology, radiography, radionuclide imaging* Humans Injections, Intravenous Male Middle Aged Neoplasm Metastasis Positron-Emission Tomography Prospective Studies Radiopharmaceuticals / diagnostic use* Tomography, X-Ray Computed |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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