Clinical Usefulness of [18F]FDG PET-CT and CT/MRI for Detecting Nodal Metastasis in Patients with Hypopharyngeal Squamous Cell Carcinoma

Na Young Shin, Jae Hoon Lee, Won Jun Kang, Yoonwoo Koh, Beomseok Sohn, Jinna Kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background and Purpose: The aim of this study was to investigate whether pretreatment imaging modalities, including [18F]fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) and CT/magnetic resonance imaging (MRI) are helpful for the selection of patient groups requiring contralateral neck dissection in patients with hypopharyngeal squamous cell carcinoma (SCC).

Methods: A total of 72 consecutive patients with histologically proven hypopharyngeal SCC who underwent both PET-CT and CT/MRI preoperatively were recruited. To assess the diagnostic accuracy of each imaging modality, the neck was divided into levels based on the imaging-based nodal classification, and the histopathologic results of the surgical specimen were used as a standard reference.

Results: Fifty-one (70.8 %) of the 72 patients had neck metastasis, and 12 (26.7 %) had contralateral metastatic nodes. The sensitivities of PET-CT and CT/MRI for detecting nodal metastasis in the contralateral neck were significantly lower than those in the ipsilateral neck (60.0 and 53.3 vs. 89.1 and 84.8 %, respectively; p < 0.001). Among the patients who underwent bilateral neck dissection (n = 45), three (13.0 %) of the 23 patients with a palpably negative neck on the ipsilateral side showed occult contralateral lymph node metastasis, while none of the 11 patients without ipsilateral metastatic nodes on imaging studies had contralateral neck metastasis.

Conclusions: With accurate assessment of ipsilateral neck metastasis in hypopharyngeal SCC patients, PET-CT and CT/MRI may be helpful in identifying patients at high risk of contralateral neck metastasis. Elective contralateral neck treatment is not necessary in hypopharyngeal SCC patients who do not show evidence of ipsilateral neck metastasis on preoperative imaging studies.

Original languageEnglish
Pages (from-to)994-999
Number of pages6
JournalAnnals of Surgical Oncology
Volume22
Issue number3
DOIs
Publication statusPublished - 2015 Jan 1

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Fluorodeoxyglucose F18
Squamous Cell Carcinoma
Neck
Magnetic Resonance Imaging
Neoplasm Metastasis
Neck Dissection
Positron Emission Tomography Computed Tomography
Patient Selection
Lymph Nodes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Shin, Na Young ; Lee, Jae Hoon ; Kang, Won Jun ; Koh, Yoonwoo ; Sohn, Beomseok ; Kim, Jinna. / Clinical Usefulness of [18F]FDG PET-CT and CT/MRI for Detecting Nodal Metastasis in Patients with Hypopharyngeal Squamous Cell Carcinoma. In: Annals of Surgical Oncology. 2015 ; Vol. 22, No. 3. pp. 994-999.
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title = "Clinical Usefulness of [18F]FDG PET-CT and CT/MRI for Detecting Nodal Metastasis in Patients with Hypopharyngeal Squamous Cell Carcinoma",
abstract = "Background and Purpose: The aim of this study was to investigate whether pretreatment imaging modalities, including [18F]fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) and CT/magnetic resonance imaging (MRI) are helpful for the selection of patient groups requiring contralateral neck dissection in patients with hypopharyngeal squamous cell carcinoma (SCC).Methods: A total of 72 consecutive patients with histologically proven hypopharyngeal SCC who underwent both PET-CT and CT/MRI preoperatively were recruited. To assess the diagnostic accuracy of each imaging modality, the neck was divided into levels based on the imaging-based nodal classification, and the histopathologic results of the surgical specimen were used as a standard reference.Results: Fifty-one (70.8 {\%}) of the 72 patients had neck metastasis, and 12 (26.7 {\%}) had contralateral metastatic nodes. The sensitivities of PET-CT and CT/MRI for detecting nodal metastasis in the contralateral neck were significantly lower than those in the ipsilateral neck (60.0 and 53.3 vs. 89.1 and 84.8 {\%}, respectively; p < 0.001). Among the patients who underwent bilateral neck dissection (n = 45), three (13.0 {\%}) of the 23 patients with a palpably negative neck on the ipsilateral side showed occult contralateral lymph node metastasis, while none of the 11 patients without ipsilateral metastatic nodes on imaging studies had contralateral neck metastasis.Conclusions: With accurate assessment of ipsilateral neck metastasis in hypopharyngeal SCC patients, PET-CT and CT/MRI may be helpful in identifying patients at high risk of contralateral neck metastasis. Elective contralateral neck treatment is not necessary in hypopharyngeal SCC patients who do not show evidence of ipsilateral neck metastasis on preoperative imaging studies.",
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Clinical Usefulness of [18F]FDG PET-CT and CT/MRI for Detecting Nodal Metastasis in Patients with Hypopharyngeal Squamous Cell Carcinoma. / Shin, Na Young; Lee, Jae Hoon; Kang, Won Jun; Koh, Yoonwoo; Sohn, Beomseok; Kim, Jinna.

In: Annals of Surgical Oncology, Vol. 22, No. 3, 01.01.2015, p. 994-999.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical Usefulness of [18F]FDG PET-CT and CT/MRI for Detecting Nodal Metastasis in Patients with Hypopharyngeal Squamous Cell Carcinoma

AU - Shin, Na Young

AU - Lee, Jae Hoon

AU - Kang, Won Jun

AU - Koh, Yoonwoo

AU - Sohn, Beomseok

AU - Kim, Jinna

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background and Purpose: The aim of this study was to investigate whether pretreatment imaging modalities, including [18F]fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) and CT/magnetic resonance imaging (MRI) are helpful for the selection of patient groups requiring contralateral neck dissection in patients with hypopharyngeal squamous cell carcinoma (SCC).Methods: A total of 72 consecutive patients with histologically proven hypopharyngeal SCC who underwent both PET-CT and CT/MRI preoperatively were recruited. To assess the diagnostic accuracy of each imaging modality, the neck was divided into levels based on the imaging-based nodal classification, and the histopathologic results of the surgical specimen were used as a standard reference.Results: Fifty-one (70.8 %) of the 72 patients had neck metastasis, and 12 (26.7 %) had contralateral metastatic nodes. The sensitivities of PET-CT and CT/MRI for detecting nodal metastasis in the contralateral neck were significantly lower than those in the ipsilateral neck (60.0 and 53.3 vs. 89.1 and 84.8 %, respectively; p < 0.001). Among the patients who underwent bilateral neck dissection (n = 45), three (13.0 %) of the 23 patients with a palpably negative neck on the ipsilateral side showed occult contralateral lymph node metastasis, while none of the 11 patients without ipsilateral metastatic nodes on imaging studies had contralateral neck metastasis.Conclusions: With accurate assessment of ipsilateral neck metastasis in hypopharyngeal SCC patients, PET-CT and CT/MRI may be helpful in identifying patients at high risk of contralateral neck metastasis. Elective contralateral neck treatment is not necessary in hypopharyngeal SCC patients who do not show evidence of ipsilateral neck metastasis on preoperative imaging studies.

AB - Background and Purpose: The aim of this study was to investigate whether pretreatment imaging modalities, including [18F]fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) and CT/magnetic resonance imaging (MRI) are helpful for the selection of patient groups requiring contralateral neck dissection in patients with hypopharyngeal squamous cell carcinoma (SCC).Methods: A total of 72 consecutive patients with histologically proven hypopharyngeal SCC who underwent both PET-CT and CT/MRI preoperatively were recruited. To assess the diagnostic accuracy of each imaging modality, the neck was divided into levels based on the imaging-based nodal classification, and the histopathologic results of the surgical specimen were used as a standard reference.Results: Fifty-one (70.8 %) of the 72 patients had neck metastasis, and 12 (26.7 %) had contralateral metastatic nodes. The sensitivities of PET-CT and CT/MRI for detecting nodal metastasis in the contralateral neck were significantly lower than those in the ipsilateral neck (60.0 and 53.3 vs. 89.1 and 84.8 %, respectively; p < 0.001). Among the patients who underwent bilateral neck dissection (n = 45), three (13.0 %) of the 23 patients with a palpably negative neck on the ipsilateral side showed occult contralateral lymph node metastasis, while none of the 11 patients without ipsilateral metastatic nodes on imaging studies had contralateral neck metastasis.Conclusions: With accurate assessment of ipsilateral neck metastasis in hypopharyngeal SCC patients, PET-CT and CT/MRI may be helpful in identifying patients at high risk of contralateral neck metastasis. Elective contralateral neck treatment is not necessary in hypopharyngeal SCC patients who do not show evidence of ipsilateral neck metastasis on preoperative imaging studies.

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