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Diagnostic Value of FDG-PET/CT for the Identification of Extranodal Extension in Patients With Head and Neck Squamous
Ryo Toya1, Tetsuo Saito2, Tomohiko Matsuyama2
1Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan ryo108@kumamoto-u.ac.jp.
Background/Aim:
We evaluated the diagnostic value of functional imaging with [18F]-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography/computed tomography (PET/CT) for the identification of extranodal extension (ENE) in patients with head and neck squamous cell carcinoma (HNSCC).
Patients And Methods:
In this study, 94 patients with HNSCC who underwent FDG-PET/CT were enrolled. We recorded the maximum standardized uptake value (SUVmax), compared the results with pathologic findings, and evaluated the diagnostic performance of using a SUVmax cut-off value for ENE.
Results:
Of the 566 dissected levels examined, 53 (9.4%) exhibited ENE. The mean SUVmax of LN with and without ENE were 6.67 and 1.64, respectively (p<0.001). A receiver operating characteristics (ROC) curve analysis for SUVmax showed an area under the ROC curve of 0.913. A SUVmax cut-off of 3.0 achieved diagnostic performance for identifying ENE with sensitivity, specificity, and accuracy of 81.1%, 94.3% and 93.1%, respectively.
Conclusion:
FDG-PET/CT findings using a SUVmax cut-off of 3.0 provides appropriate diagnostic value in identifying ENE.
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