Palatine tonsil SUVmax on FDG PET-CT as a discriminator between benign and malignant tonsils in patients with and without head and neck squamous cell carcinoma of unknown primary
| Autor: | Gary Cook, N. Sriskandan, Selvam Thavaraj, Steve Connor, Richard Oakley, J.P. Jeannon, Mary Lei, Joel Dunn, Ata Siddiqui, Teresa Guerrero-Urbano, Teresa Szyszko, D. Pencharz |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Tonsillar Carcinoma Palatine Tonsil Malignancy Sensitivity and Specificity Palatine tonsil 030218 nuclear medicine & medical imaging Diagnosis Differential 03 medical and health sciences 0302 clinical medicine stomatognathic system Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography Biopsy medicine Humans Radiology Nuclear Medicine and imaging In patient Aged Retrospective Studies Aged 80 and over Receiver operating characteristic medicine.diagnostic_test business.industry Squamous Cell Carcinoma of Head and Neck Reproducibility of Results Retrospective cohort study General Medicine Middle Aged medicine.disease Head and neck squamous-cell carcinoma medicine.anatomical_structure Head and Neck Neoplasms 030220 oncology & carcinogenesis Neoplasms Unknown Primary Female Radiopharmaceuticals business Nuclear medicine |
| Zdroj: | Pencharz, D, Dunn, J, Connor, S, Siddiqui, A, Sriskandan, N, Thavaraj, S, Jeannon, J-P, Oakley, R, Lei, M, Guerrero-Urbano, T, Cook, G J & Szyszko, T A 2018, ' Palatine tonsil SUVmax on FDG PET-CT as a discriminator between benign and malignant tonsils in patients with and without head and neck squamous cell carcinoma of unknown primary ', Clinical Radiology . https://doi.org/10.1016/j.crad.2018.10.007 |
| ISSN: | 1365-229X |
| Popis: | AIM: To analyse the maximum standardised uptake value (SUVmax) ratio between tonsils in patients with and without tonsillar carcinoma to determine useful diagnostic thresholds.MATERIALS AND METHODS: Positron-emission tomography (PET)/computed tomography (CT) examinations of patients with suspected head and neck squamous cell carcinoma (SCC) and controls from April 2013 to September 2016 were reviewed retrospectively. Tonsillar SUVmax ratios (ipsilateral/contralateral for malignant tonsils, maximum/minimum for patients without [controls]) were calculated and used to construct a receiver operating characteristic (ROC) curve.RESULTS: Twenty-five patients had tonsillar carcinoma (mean SUVmax ratio of 2, range 0.89-5.4) and 86 patients acted as controls (mean SUVmax ratio of 1.1, range 1-1.5). Using the ROC, the most accurate SUVmax ratio for identifying malignancy was >1.2 (77% sensitivity, 86% specificity). A potentially more clinically useful SUVmax ratio is ≥1.6 with 62% sensitivity and 100% specificity.CONCLUSION: An SUVmax ratio between tonsils of ≥1.6 is highly suspicious for SCC and could be used to direct site of biopsy. Some malignant tonsils had normal FDG uptake; therefore, PET/CT should not be used to exclude tonsillar cancer. Minor asymmetrical uptake is frequently seen in non-malignant tonsils and does not necessarily require further investigation. Due to the single centre nature of this study and the recognised variation in SUV measurements between PET scans, other centres may need to develop their own cut-offs. |
| Databáze: | OpenAIRE |
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