두경부암 환자에서 경부림프절 전이에 대한 18F FDG-PET과 CT/MRI의 진단적 정확도 비교: 림프절 군에 따른 연구 (Comparison of 18F FDG-PET and CT/MRI for the Diagnosis of Cervical Lymph Node Metastasis in Head and Neck Cancer: A Level-by-Level Based Study) |
Author |
양유정, 김재승, 김상윤, 이호규, 남순열, 최승호, 류진숙, 여정석, 문대혁, |
YooJung Yang, M.D., Jae Seung Kim, M.D., Sang Yun Kim, M.D., Ho Gyu Lee, M.D.,Soon Yul Nam, M.D., Seung Ho Choi, M.D., Jin Sook Ryu, M.D., Jung Suk Yeo, M.D.,Dae Hyuk Moon, M.D. |
Affiliation |
울산대학교 의과대학 서울아산병원 핵의학과, 이비인후과, 방사선과 Departments of Nuclear Medicine, Otolaryngology, and Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. |
Abstract |
Cervical lymph node metastasis is the most important factor of the prognosis and therapeutic
planning in head and neck cancer. With increasing interest of minimally invasive neck surgery, more
accurate preoperative assessment of cervical lymph node becomes more essential. We evaluated the
diagnostic accuracy of 18F FDG-PET in the assessment of lymph node metastasis in patients with primary
head and neck cancer and compared the results with those of CT/MRI. Materials and Methods:
Thirty-two patients (M/F=27/5, 56¡¾10yr) with biopsy proven head and neck cancer (16 supraglottic cancer,
9 tongue cancer, 7 others) underwent FDG-PET and CT/MRI (25/7) within 1 month before neck dissection.
Based on lymph node level, the diagnostic sensitivity and specificity of FDG PET and CT/MRI for the
metastasis of cervical lymph node were compared. Results: Of 153 lymph node levels dissected in 32
patients, 32 lymph node levels of 19 patients were positive for metastasis by histopatholologic examination.
The overall sensitivity and specificity of FDG-PET were 88% (28/32) and 93% (113/121), whereas those of
CT/MRI were 56% (18/32) (p=0.002) and 92% (112/121), respectively. The diagnostic sensitivity and
specificity of FDG-PET were different according to location of lymph node levels, and those of ipsilateral
level II were lower than those of other levels. Conclusion: FDG-PET is more sensitive in detecting
metastatic cervical lymph node in head and neck cancer than CT/MRI. FDG-PET might be useful in guiding
the extent of neck dissection. |
Keyword |
Head and neck cancer, FDG-PET, CT, Lymph node metastasis |
Full text Article |
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