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J Nucl Med. 2008; 49 (Supplement 1):359P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

Detection of recurrence adjacent to surgical clips using FDG-PET/CT and contrast enhanced CT (CECT) in squamous cell carcinoma of the head and neck (HNSCC)

Bharat Mocherla1, Jongho Kim1, Peter Som1, Eric Genden2, Josef Machac1, Sherif Heiba1 and Lale Kostakoglu1

1 Radiology; 2 Otolaryngology, Mount Sinai Medical Ctr, New York, New York

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Objectives: Our aim was to determine the diagnostic accuracy of FDG-PET/CT using various reading scales and use CECT as an adjunct to better define post-surgical anatomy in the identification of recurrence adjacent to surgical clips (SC).

Methods: A total of 97 foci with increased FDG uptake located next to SCs were assessed using PET/CT and CECT in 40 HNSCC pts. Diagnostic validation was done by biopsy or follow-up (median 12 mo). SUV lean body mass (SUVlbm), tm-to-liver (T/L), tm-to-mediastinal blood pool (T/MBP), tm-to-submandibular gland (T/SMG), tm-to-contralateral (T/CL) ratios were calculated. ROC analyses were performed. CECT findings were evaluated for the presence of soft tissue abnormalities.

Results: Both T/L and T/MBP ratios yielded more favorable results compared to other ratios.


Figure 1
Identification of Recurrence by FDG/PET Parameters and CECT

SUVlbm of 3.3 yielded the best cut-off for identification of malignancy adjacent to SCs. CECT had an inferior sensitivity but comparable specificity and increased reading confidence of PET/CT by providing exquisite morphologic information.

Conclusions: In the identification of recurrece adjacent to SCs, 1. FDG PET/CT had a superior accuracy to CECT, but CECT increases interpretation confidence 2. Both T/L and T/MBP ratios yielded higher PPV, specificity and accuracy than T/CL and T/SMG ratios.





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Right arrow Articles by Mocherla, B.
Right arrow Articles by Kostakoglu, L.