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Head & Neck Oncology
Published in: Head & Neck Oncology 1/2010

Open Access 01-12-2010 | Research

FDG-PET staging and importance of lymph node SUV in head and neck cancer

Authors: Gregory J Kubicek, Collin Champ, Shannon Fogh, Fen Wang, Eashwer Reddy, Charles Intenzo, Reginald W Dusing, Mitchell Machtay

Published in: Head & Neck Oncology | Issue 1/2010

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Abstract

Objectives

The role of positron emission tomography (PET) with fluoro-deoxy-glucose (FDG) in the staging of head and neck cancer (HNC) is unclear. The NCCN guidelines do not recommend FDG-PET as a part of standard workup. The purpose of this report is to examine the role of FDG-PET imaging in altering management and providing prognostic information for HNC.

Methods

Retrospective review of HNC patients who had a staging FDG-PET scan performed at either Thomas Jefferson University or University of Kansas Medical Center between the years 2001 and 2007. A total of 212 PET scans were performed in patients who went on to receive radiotherapy.

Results

The median follow-up time for all patients was 469 days. The PPV and NPV of PET imaging to correctly identify lymph node status was 94% and 89% respectively. Lymph nodes with extracapsular extension (ECE) had higher SUVs than nodes without ECE, 11.0 vs. 5.0 (p < 0.0007). Maximum SUV for the primary tumor > 8.0 was predictive of worse overall survival (p < 0.045), while the SUV of the lymph nodes was predictive for distant recurrence at one year--with a mean SUV value of 10.4 for patients with distant failure vs. 7.0 without (p < 0.05).

Conclusions

FDG-PET staging in head and neck cancer has good positive and negative predictive values in determining lymph node status. The maximum SUV of the primary tumor is predictive of overall survival. This is the first report to find that the SUV of a lymph node is predictive for ECE and also for distant recurrence.
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Metadata
Title
FDG-PET staging and importance of lymph node SUV in head and neck cancer
Authors
Gregory J Kubicek
Collin Champ
Shannon Fogh
Fen Wang
Eashwer Reddy
Charles Intenzo
Reginald W Dusing
Mitchell Machtay
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Head & Neck Oncology / Issue 1/2010
Electronic ISSN: 1758-3284
DOI
https://doi.org/10.1186/1758-3284-2-19

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