Pathology and FDG PET correlation of residual lymph nodes in head and neck cancer after radiation treatment

Min Yao; Pifu Luo; Henry T Hoffman; Kristi Chang; Michael M Graham; Yusuf Menda; Huaming Tan; John M Buatti

doi:10.1097/01.coc.0000257611.65290.aa

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Pathology and FDG PET correlation of residual lymph nodes in head and neck cancer after radiation treatment

Journal article

Peer reviewed

Pathology and FDG PET correlation of residual lymph nodes in head and neck cancer after radiation treatment

Min Yao, Pifu Luo, Henry T Hoffman, Kristi Chang, Michael M Graham, Yusuf Menda, Huaming Tan and John M Buatti

American journal of clinical oncology, Vol.30(3), pp.264-270

06/2007

DOI: 10.1097/01.coc.0000257611.65290.aa

PMID: 17551303

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Abstract

This study determines if postradiotherapy [18F]fluorodeoxyglucose positron emission tomography (FDG PET) can predict the pathology status of residual cervical lymph nodes in patients undergoing definitive radiotherapy for head and neck squamous cell carcinoma (HNSCC). Patients with stage N2 or higher HNSCC underwent PET and CT imaging after definitive radiotherapy. Patients with radiographically persistent lymphadenopathy underwent either neck dissection or fine needle aspiration (FNA) of the lymph nodes under ultrasound guidance. PET scan results were correlated with the pathologic findings of the residual lymphadenopathy. Twenty-four hemi-necks in 23 patients with residual lymphadenopathy had neck dissection or FNA. The pathology correlated strongly with the post-RT FDG PET studies. All patients with a negative post-RT FDG PET and those with a maximum standardized uptake value (SUVmax) of less than 3.0 in the post-RT FDG PET were found to be free from residual viable tumor. Using a SUVmax of less than 3.0 as the criterion for a negative FDG PET study, the sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 84.2%, 62.5%, and 100%, respectively. A negative post-RT FDG PET is very predictive of negative pathology in the residual lymph node after definitive radiotherapy for advanced HNSCC. A prospective clinical trial is warranted to determine if neck dissection can be withheld in these patients.

Lymphatic Metastasis - diagnosis

Lymphatic Metastasis - radiotherapy

Carcinoma, Squamous Cell - pathology

Head and Neck Neoplasms - diagnostic imaging

Humans

Middle Aged

Male

Carcinoma, Squamous Cell - diagnostic imaging

Positron-Emission Tomography

Carcinoma, Squamous Cell - radiotherapy

Head and Neck Neoplasms - pathology

Carcinoma, Squamous Cell - diagnosis

Biopsy, Fine-Needle

Head and Neck Neoplasms - radiotherapy

Lymphatic Metastasis - diagnostic imaging

Lymphatic Metastasis - pathology

Sensitivity and Specificity

Adult

Female

Fluorodeoxyglucose F18

Head and Neck Neoplasms - diagnosis

Aged

Radiopharmaceuticals

Details

Title: Subtitle: Pathology and FDG PET correlation of residual lymph nodes in head and neck cancer after radiation treatment
Creators: Min Yao - Departments of Radiation Oncology, University of Iowa Health Care, Iowa City, IA, USA. min-yao@uiowa.edu
Pifu Luo
Henry T Hoffman
Kristi Chang
Michael M Graham
Yusuf Menda
Huaming Tan
John M Buatti
Resource Type: Journal article
Publication Details: American journal of clinical oncology, Vol.30(3), pp.264-270
Publisher: United States
DOI: 10.1097/01.coc.0000257611.65290.aa
PMID: 17551303
ISSN: 0277-3732
eISSN: 1537-453X
Language: English
Date published: 06/2007
Academic Unit: Radiology; Radiation Oncology; Neurosurgery; Otolaryngology
Record Identifier: 9984006344702771

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