Positron-emission tomography enhancement after vocal fold injection medialization

Area of Science:

• Otolaryngology
• Nuclear Medicine
• Radiology

Background:

• Positron-emission tomography (PET) scans using 18F-fluorodeoxyglucose (FDG) are crucial for diagnosing malignancy.
• Increased FDG uptake in vocal folds after augmentation medialization can mimic malignancy, potentially leading to misdiagnosis.

Purpose of the Study:

• To investigate the extent and variability of FDG uptake in vocal folds following augmentation medialization.
• To determine if there is a correlation between FDG uptake differences and the time elapsed since vocal fold augmentation.

Main Methods:

• Retrospective chart review of 15 adult patients who underwent unilateral vocal fold augmentation and subsequent PET scans.
• Comparison of standard uptake values (SUV) between injected and noninjected vocal folds using the Wilcoxon signed-rank test.
• Spearman rank correlation analysis to assess the relationship between SUV differences and time to PET scan.

Main Results:

• The mean SUV in injected vocal folds (3.70) was higher than in noninjected folds (2.97), but the difference was not statistically significant (p = 0.34).
• No significant correlation was found between the difference in PET uptake and the time between injection and the PET scan (r = -0.24, p = 0.34).
• PET uptake after vocal fold augmentation is variable and can be substantially increased.

Conclusions:

• Vocal fold augmentation medialization can lead to variable and potentially significant increases in FDG uptake on PET scans.
• This increased uptake may mimic malignancy, impacting diagnostic accuracy.
• Clinicians should consider postsurgical changes when interpreting PET scans in patients with vocal fold augmentation.