Lymph node metastasis of squamous cell carcinoma from an unknown primary: impact of positron emission tomography
Sandro Stöckli, Katarzyna Mosna-Firlejczyk & Gerhard W Goerres
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abstract
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This study was performed to assess the potential benefit of positron
emission tomography (PET) using fluorine-18 fluorodeoxyglucose (FDG)
in patients with cervical metastasis of squamous cell carcinoma from
an unknown primary tumour. Eighteen patients with cervical
metastasis of squamous cell carcinoma from an unknown primary who
were assessed by physical examination including transnasal
fibre-endoscopy and radiological work-up with computed tomography
were included in this prospective tertiary referral centre cohort
study. The results of the search for the primary with rigid
panendoscopy of the upper aerodigestive tract were compared to the
evaluation with FDG PET. Panendoscopy revealed a primary tumour in
8/18 (44%) patients. PET accurately diagnosed five of these eight
primary tumours, and gave one false positive and three false
negative scans, resulting in a sensitivity of 63%, a specificity of
90%, an accuracy of 78%, a positive predictive value of 83% and a
negative predictive value of 75%. Small primaries or primaries in
areas with physiologically increased FDG uptake can be missed with
PET owing to the limited resolution of the camera (approximately 5
mm). Our study in a small number of patients suggests that PET does
not provide benefit in terms of detecting additional primary tumours
if applied in addition to extensive clinical work-up. Considering
its high specificity, PET could be of value as an initial evaluation
instrument, reserving the need for extensive work-up to patients
with negative scans.
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citation
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Stöckli S, Mosna-Firlejczyk K, Goerres G W. Lymph node metastasis
of squamous cell carcinoma from an unknown primary: impact of
positron emission tomography. European journal of nuclear medicine
and molecular imaging 2003; 30:411-6.
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type
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journal paper/review (English)
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date of publishing
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3-2003
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journal title
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European journal of nuclear medicine and molecular imaging (30/3)
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ISSN print
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1619-7070
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pages
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411-6
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PubMed
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12634970
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DOI
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10.1007/s00259-002-1078-9
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