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CT, MR, US, 18F-FDG PET/CT, and their combined use for the assessment of cervical lymph node metastases in squamous cell carcinoma of the head and neck

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Abstract

The purpose of this retrospective study was to compare the diagnostic value of four different imaging methods—computed tomography (CT), magnetic resonance (MR) imaging, ultrasonography (US), and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT—and their combined use for preoperative detection of cervical nodal metastases in head and neck squamous cell carcinoma (SCC). Sixty-seven patients (58 men and 9 women; mean age, 60.1 years) with head and neck SCCs underwent CT, MR, US, and PET/CT before surgery. First, each study was reviewed separately for the presence of nodal metastases. Then, the value of combined images was assessed based on a confidence rating score for each modality assigned by observers. These results were verified, on a level-by-level basis, with histopathologic findings. Histopathologic examination revealed nodal metastases in 74 of 402 nodal levels. The sensitivity, specificity, and accuracy were 77.0%, 99.4%, and 95.3% for CT and MR; 78.4%, 98.5%, and 94.8% for US; and 81.1%, 98.2%, and 95.0% for PET/CT, respectively. The comparison of these modalities showed no statistically significant difference among them (p > 0.05). The combination of CT, MR, US, and PET/CT improved sensitivity (86.5%), without loss of specificity (99.4%) and accuracy (97.0%), although the difference failed to reach statistical significance.

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Authors and Affiliations

  1. Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong Kangdong-Gu, Seoul, 134–701, Republic of Korea

    Dae Young Yoon & Suk Ki Chang

  2. Department of Nuclear Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 896, Pyongchon-dong, Dongan-gu, Anyang, Kyunggi-do, 431–070, Republic of Korea

    Hee Sung Hwang

  3. Department of Otorhinolaryngology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong, Kangdong-Gu, Seoul, 134–701, Republic of Korea

    Young-Soo Rho, Hwoe Young Ahn & Jin Hwan Kim

  4. Department of Radiology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 896, Pyongchon-dong, Dongan-gu, Anyang, Kyunggi-do, 431–070, Republic of Korea

    In Jae Lee

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  1. Dae Young Yoon
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Yoon, D.Y., Hwang, H.S., Chang, S.K. et al. CT, MR, US, 18F-FDG PET/CT, and their combined use for the assessment of cervical lymph node metastases in squamous cell carcinoma of the head and neck. Eur Radiol 19, 634–642 (2009). https://doi.org/10.1007/s00330-008-1192-6

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  • DOI: https://doi.org/10.1007/s00330-008-1192-6

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