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Nuklearmedizin 2004; 43(03): 91-101
DOI: 10.1055/s-0038-1625597
Original Article
Schattauer GmbH

18F-FDG PET for detecting recurrent head and neck cancer, local lymph node involvement and distant metastases

Comparison of qualitative visual and semiquantitative analysis 18F-FDG-PET zum Nachweis eines Lokalrezidivs, lokoregionärer Lymphknotenund Fernmetastasen bei KopfHals-TumorenVergleich einer qualitativ-visuellen mit einer semiquantitativen Auswertung
M. Schmidt
1   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. med. H. Schicha)
,
M. Schmalenbach
1   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. med. H. Schicha)
,
M. Jungehülsing
3   Klinik für Hals-, Nasen- und Ohrenheilkunde, Klinikum Ernst von Bergmann, Potsdam, Germany
,
P. Theissen
1   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. med. H. Schicha)
,
M. Dietlein
1   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. med. H. Schicha)
,
U. Schröder
2   Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde (Direktor: Prof. Dr. med. E. Stennert), Universität zu Köln, Köln, Germany
,
W. Eschner
1   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. med. H. Schicha)
,
E. Stennert
2   Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde (Direktor: Prof. Dr. med. E. Stennert), Universität zu Köln, Köln, Germany
,
H. Schicha
1   Klinik und Poliklinik für Nuklearmedizin (Direktor: Prof. Dr. med. H. Schicha)
› Author Affiliations
Further Information

Publication History

Received: 17 October 2003

in revised form: 22 January 2004

Publication Date:
10 January 2018 (online)

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Summary

Aim: Assessment of the clinical value of 18F-FDG-PET for detection of recurrent head and neck cancer, local lymph node involvement and distant metastases comparing a qualitative visual with a semiquantitative analysis (SUV values). Patients, methods: Retrospective evaluation of 73 18F-FDG PET studies in 55 patients by use of a four-step qualitative visual grading system and calculation of standard uptake values in pathological lesions. Calculation of SUV values in normal regions for generating a map of physiological 18F-FDG distribution. Correlation to histopathological findings and clinical follow-up. Results: 1. Qualitative visual analysis of 18F-FDG PET studies: a) local recurrence sensitivity 79%, specificity 97%, positive predictive value 95%, negative predictive value 85%, and diagnostic accuracy 89%; b) local metastatic lymph nodes 100%, 95%, 85%, 100%, 96%; c) distant metastases 100%, 98%, 86%, 100%, 98%, respectively. 2. Semiquantitative analysis had only little incremental, non-significant value in comparison to qualitative visual analysis for the detection of a local recurrence in two patients: a) local recurrence: sensitivity 83%, specificity 100%, positive predictive value 100%, negative predictive value 88%, and diagnostic accuracy 93%; b) local metastatic lymph nodes or c) distant metastases did not change in comparison to qualitative visual analysis. Conclusion: 18F-FDG PET is an effective tool for re-staging of patients with suspected recurrence after therapy for head and neck cancer.

Zusammenfassung

Ziel: Untersuchung zum klinischen Wert der 18F-FDGPET zum Nachweis eines Lokalrezidivs, lokoregionärer Lymphknoten- und Fernmetastasen bei Patienten mit Kopf-Hals-Tumoren und Rezidivverdacht. Vergleich einer qualitativ-visuellen mit einer semiquantitativen (SUVWerte) Bildauswertung. Patienten und Methoden: Retrospektive Beurteilung von 73 18F-FDG-PET-Untersuchungen bei 55 Patienten mittels vierstufiger visuellqualitativer Bewertungsskala und über Bestimmung von SUV-Werten in pathologischen Herdbefunden. Bestim-mung von SUV-Werten in normalen Regionen zur Erstel-lung einer Karte physiologischer 18F-FDG-Anreicherung. Korrelation zu histopathologischen Befunden und klinischen Verläufen. Ergebnisse: 1. Qualitativ-visuelle Auswertung der 18F-FDG-PET-Untersuchungen: a) Lokalrezidiv: Sensitivität 79%, Spezifität 97%, positiver prädiktiver Wert 95%, negativer prädiktiver Wert 85% und diagnostische Genauigkeit 89%; b) lokoregionäre Lymphknotenmetastasen: 100%, 95%, 85%, 100%, 96%; c) Fernmetastasen: 100%, 98%, 86%, 100%, 98%. 2. Die semiquantitative Analyse erbrachte nur einen geringen inkrementalen, nicht signifikanten Nutzen im Vergleich zur qualitativ-visuellen Bildauswertung bei zwei Patienten in der Detektion des Lokalrezidivs: a) Lokalrezidiv: Sensitivität 83%, Spezifität 100%, positiver prädiktiver Wert 100%, negativer prädiktiver Wert 88% und diagnostische Genauigkeit 93%; b) lokoregionäre Lymphknoten- oder c) Fernmetastasen ohne Befundänderung im Vergleich zur qualitativ-visuellen Auswertung. Schlussfolgerung: 18F-FDG-PET ist ein effektives Verfahren zum Re-Staging von Patienten mit behandelten Kopf-Hals-Tumoren und Rezidivverdacht.

Keywords

18F-FDG positron emission tomography - recurrent head and neck cancer - metastases - standard uptake value

Schlüsselwörter

18F-FDG-Positronenemissionstomographie - Kopf-Hals-Tumor-Rezidiv - Metastasen - standard uptake value
 

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