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Contrast-enhanced (18) F-FDG-PET/CT for the assessment of necrotic lymph node metastases

Stephan K Haerle, Klaus Strobel, Nader Ahmad, Alex Soltermann, Daniel T Schmid & Sandro Stöckli

abstract BACKGROUND.: Cystic lymph node metastasis (CLNM) is commonly found in human papillomavirus (HPV)-associated tonsillar squamous cell carcinoma (SCC). The aim of this study was to compare the accuracy in detecting cystic lymph node metastasis from tonsillar SCC between contrast-enhanced CT, (18) F- fluorodeoxyglucose-positron emission tomography (FDG-PET), non-enhanced (18) F-FDG-PET/CT, and contrast-enhanced (18) F-FDG-PET/CT. METHODS.: Thirty-four patients with a tonsillar SCC undergoing a pretreatment contrast-enhanced (18) F-FDG-PET/CT followed by a neck dissection as a standard of reference were included. The contrast-enhanced CT part, the (18) F-FDG-PET part, the non-enhanced (18) F-FDG-PET/CT part, and the contrast-enhanced (18) F-FDG-PET/CT were assessed separately for correct N classification and the differentiation of N0 versus N+. RESULTS.: Contrast-enhanced (18) F-FDG-PET/CT, non-enhanced (18) F-FDG-PET/CT, and contrast-enhanced CT are equally accurate for correct neck staging. Regarding pN0 versus pN+, contrast-enhanced CT and contrast-enhanced (18) F-FDG-PET/CT are superior to non-enhanced (18) F-FDG-PET/CT (p = .017). CONCLUSION.: Contrast-enhanced CT and contrast-enhanced (18) F-FDG-PET/CT perform equally and better than non-enhanced (18) F-FDG-PET/CT in detecting CLNM in tonsillar SCC. Therefore, in patients scheduled for (18) F-FDG-PET/CT, we strongly suggest performing a contrast-enhanced (18) F-FDG-PET/CT, which is not routine in most centers. © 2010 Wiley Periodicals, Inc. Head Neck, 2010.
   
citation Haerle S K, Strobel K, Ahmad N, Soltermann A, Schmid D T, Stöckli S. Contrast-enhanced (18) F-FDG-PET/CT for the assessment of necrotic lymph node metastases. Head Neck 2011; 33:324-9.
   
type journal paper/review (English)
date of publishing 3-2011
journal title Head Neck (33/3)
ISSN electronic 1097-0347
pages 324-9
PubMed 20652890
DOI 10.1002/hed.21447