Head and Neck Cancer: Clinical Usefulness and Accuracy of PET/CT Image Fusion
| Autor: | Heiko Schöder, Henry W.D. Yeung, Dennis H. Kraus, Mithat Gonen, Steven M. Larson |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Sensitivity and Specificity McNemar's test Fluorodeoxyglucose F18 Image Interpretation Computer-Assisted Carcinoma medicine Humans False Positive Reactions Radiology Nuclear Medicine and imaging Muscle Skeletal Aged Retrospective Studies Aged 80 and over Fluorodeoxyglucose PET-CT medicine.diagnostic_test business.industry Head and neck cancer Retrospective cohort study Middle Aged medicine.disease Head and Neck Neoplasms Positron emission tomography Carcinoma Squamous Cell Female Lymph Nodes Patient Care Radiology Tomography Radiopharmaceuticals Tomography X-Ray Computed Nuclear medicine business Follow-Up Studies Tomography Emission-Computed medicine.drug |
| Zdroj: | Radiology. 231:65-72 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.2311030271 |
| Popis: | To compare diagnostic accuracy of attenuation-corrected positron emission tomography (PET) with fused PET and computed tomography (CT) in patients with head and neck cancer and to evaluate the effect of PET/CT findings on patient care.Studies of 68 patients were reviewed by two physicians in consensus. Focal fluorodeoxyglucose (FDG) uptake in the head and neck on attenuation-corrected PET images was graded as benign, equivocal, or malignant. CT and PET/CT images were then reviewed, and initial findings were amended if necessary. Comparison was performed on a lesion-by-lesion basis. Accuracy was evaluated on the basis of follow-up and histopathologic findings. Potential effects on patient care were assessed by a head and neck surgeon. PET and PET/CT accuracy was compared with a McNemar test adjusted for clustering.A total of 157 foci with abnormal FDG uptake were noted, two of which were seen only on PET/CT images. PET/CT images were essential in determining the exact anatomic location for 100 lesions (74% better localization in regions previously treated surgically or with irradiation vs 58% in untreated areas; P =.06). On the basis of PET findings alone, 45 lesions were considered benign; 39, equivocal; and 71, malignant. With PET/CT, the fraction of equivocal lesions decreased by 53%, from 39 of 155 to 18 of 157 (P.01). PET/CT had a higher accuracy of depicting cancer than did PET (96% vs 90%, P =.03). Six proved malignancies were missed with PET, but only one was missed with PET/CT. PET/CT findings altered the care for 12 (18%) of 68 patients.PET/CT is more accurate than PET alone in the detection and anatomic localization of head and neck cancer and has the clear potential to affect patient care. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|