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Nuklearmedizin 2000; 39(08): 246-250
DOI: 10.1055/s-0038-1632275
Original Article
Schattauer GmbH

Direct comparison of F-l 8-FDG PET and ultrasound in the follow-up of patients with squamous cell cancer of the head and neck

Direkter Vergleich von F-18-FDG PET mit Ultraschall für Nachsorgekontrollen von Patienten mit Plattenepithelkarzinomen im HNO-Bereich
G. W. Goerres
1   Division of Nuclear Medicine, University Hospital Zurich;
,
C. A. Haenggeli
2   ENT Clinics
,
M. Allaoua
3   Division of Nuclear Medicine
,
S. R. Albrecht
3   Division of Nuclear Medicine
,
P. Dulguerov
2   ENT Clinics
,
M. Becker
4   Department of Radiology, and
,
A. S. Allai
5   division of Radiooncology, University Hospitals, Geneva, Switzerland
,
W. Lehmann
2   ENT Clinics
,
D. O. Slosman
3   Division of Nuclear Medicine
› Author Affiliations
Further Information

Publication History

Received: 02 June 2000

in revised form: 20 August 2000

Publication Date:
01 February 2018 (online)

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Summary

Aim: The objective of this study was to compare screening ultrasound (US) obtained in patients with squamous cell carcinoma of the head and neck with F-l 8-FDG PET and to evaluate if US obtained before F-l 8-FDG PFT has the potential to enhance patient management by the detection of additional lesions. Method: 28 patients were prospectively included in the study (7 females and 21 males; range: 28-82 years). All had one follow-up examination after surgical treatment and/or radiotherapy using a combination of US and F-l 8-FDG PET on the same day (6-35 months after the end of treatment). Outcome was determined by either biopsyproven cancer recurrence or negative clinical follow-up for additional 6 months after this examination. Results: Regarding only the regions of the neck evaluated with both methods, US detected 25 suspect lesions vs. 9 lesions detected by F-l 8-FDG PET. Descriptive statistical analysis showed better sensitivity, specificity and accuracy of F-l 8-FDG PET. Only in 3 patients a lesion was detected in the same anatomical region using both methods. One patient was false positive with both methods. In another patient US detected a calcified right carotid artery plaque that lead to surgical therapy. Conclusion: F-l 8-FDG PET is better for the detection of clinically relevant lesions in the follow-up of patients with squamous cell carcinoma of the head and neck. In this study, the additional value of morphological information obtained by screening US performed before the PET scan is limited. US may not be a suitable test to improve interpretation of PET examinations.

Zusammenfassung

Ziel: Ziel dieser Studie war es, die Sonographie des Halses bei Patienten mit Plattenepithelkarzinomen im HNO-Bereich mit der F-l 8-FDG PET zu vergleichen und zu evaluieren, ob eine Ultraschalluntersuchung (US) die Nachsorge von Patienten durch die Erkennung zusätzlicher Befunde verbessert. Methode: 28 Patienten wurden prospektiv in die Studie eingeschlossen (7 Frauen, 21 Männer; Alter zwischen 28 und 82 Jahren). Sämtliche Patienten kamen nach erfolgter Chirurgie/Strahlentherapie zu einer kombinierten Untersuchung, die aus US und F-l 8-FDG PET bestand und gleichentags durchgeführt wurde (6-35 Monate nach Ende der Therapie). Als Vergleich diente entweder die histologische Bestätigung eines Rezidivs oder eine negative Nachsorgekontrolle mindestens 6 Monate nach erfolgter Untersuchung. Ergebnisse: Bei Vergleich nur derjenigen Regionen am Hals, welche sowohl mit US als auch mit F-l 8-FDG PET untersucht wurden, fanden sich mit US 25 weiter abklärungsbedürftige Veränderungen gegenüber 9 Läsionen, die mit der F-l 8-FDG PET gesehen wurden. Sensitivität, Spezifität und Genauigkeit der Untersuchungen waren besser mit der F-l 8-FDG PET. Nur bei 3 Patienten wurde eine suspekte Läsion mit beiden Methoden an der gleichen Stelle beschrieben. Ein Patient war mit beiden Untersuchungen falsch positiv beurteilt worden. Bei einem weiteren Patienten konnte mit US ein verkalkter Karotisplaque gefunden werden, der anschließend chirurgisch behandelt wurde. Schlussfolgerung: Die F-l 8-FDG PET ist dem US in der Erkennung von klinisch relevanten Läsionen bei Patienten mit Plattenepithelkarzinomen im HNO-Bereich überlegen. In dieser Studie war der Wert zusätzlicher morphologischer Information des US limitiert. Eine US-Untersuchung, die ohne Kenntnisse des PET-Befundes durchgeführt wird, scheint nicht zu einer Verbesserung der Interpretierbarkeit der PET-Untersuchung zu führen.

Keywords

Positron emission tomography - sonography - head and neck cancer - follow-up examination - screening - ultrasound

Schlüsselwörter

Positronenemissionstomographie - Ultraschall-Screening - HNO-Tumor - Nachsorgeuntersuchung - Sonographie
 

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