Document Detail


Staging primary head and neck cancers with (18)F-FDG PET/CT: is intravenous contrast administration really necessary?
MedLine Citation:
PMID:  19352652     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Keisuke Yoshida; Akiko Suzuki; Toshiyuki Nagashima; Jin Lee; Choichi Horiuchi; Mamoru Tsukuda; Tomio Inoue
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-08
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:  1417-24     Citation Subset:  IM    
Affiliation:
Department of Radiology, Yokohama City University, 3-9 Fukuura, Yokohama, Japan. kei-yoshida@nyc.odn.ne.jp
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MeSH Terms
Descriptor/Qualifier:
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:
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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