J Nucl Med. 2008; 49 (Supplement 1):179P
Educational Exhibits (Poster Only)Oncology Posters |
Spectrum of F18-FDG PET/CT findings in oncology-related recurrent laryngeal nerve palsy: Cases and anatomy review
Maria Komissarova1,
Ka Kit Wong1,
Morand Piert1,
Suresh Mukherji1 and
Lorraine Fig2
1 Nuclear Medicine, University of Michigan, Ann Arbor, Michigan;
2 Nuclear Medicine, Veterans Affairs Hospital, Ann Arbor, Michigan
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Learning Objectives: 1. Describe the gross and cross-sectional anatomy of the recurrent laryngeal nerve. 2. Identify the typical PET/CT features of recurrent laryngeal nerve palsy. 3. Know the main locations of nerve injury and typical causal tumors.
Abstract Body: Recurrent laryngeal nerve palsy (RLNP) in cancer patients imaged with F18-FDG PET/CT may be related to the tumor or therapy. It is important for nuclear medicine physicians to be familiar with the anatomic course of the recurrent laryngeal nerve (RLN) and scintigraphic features of RNLP. The paired RLNs arise from the vagus nerves and innervate laryngeal musculature primarily involved with phonation. Interruption of the RLN results in paralysis of the ipsilateral vocal cord, often presenting as hoarseness and dysphonia. Oncology patients are at increased risk for RLNP from direct tumor invasion/compression or surgical injury. Increased FDG uptake in the normal vocal cord contralateral to the RLN injury, typically accompanied by asymmetric laxity of the ipsilateral, paralyzed cord, should be recognized as highly suggestive of RLNP. Potential serious consequences of vocal cord paralysis are dysphagia and aspiration, therefore this finding should be promptly reported to the clinicians. A small proportion of RLNP cases may be idiopathic, or due to external beam or chemotherapy, therefore RLNP should be considered even in the absence of neoplasm along the nerve course. In this exhibit we illustrate the complex course of the RLN using a series of transaxial CT images and present 6 cases showing the typical FDG PET/CT imaging appearance, a range of clinical presentations and locations of RNL injury.
