Value of F-18 FDG PET/CT in diagnosis of cervical lymph node metastasis of head and neck squamous cell carcinoma: comparison with CT and MRI

Abstract

Background and Objectives Cervical lymph node metastasis is a very important prognostic factor of head and neck squamous cell carcinoma (HNSCC). Therefore, strict evaluation of cervical lymph node metastasis is necessary for accurate staging and proper treatment planning. This study compares computed tomography (CT) and magnetic resonance imaging (MRI) to position emission tomography-computed tomography (PET-CT), and evaluates the clinical role of PET-CT in the diagnosis of cervical metastasis of HNSCC.Subjects and Method From October 2004 to September 2010, we studied 74 patients with HNSCC who underwent PET-CT, CT and MRI before undergoing neck dissection for the treatment of cervical lymph node metastasis. We compared pathologic results of 374 cervical lymph node levels in 74 patients with results of PET-CT, CT and MRI. We analyzed and compared sensitivity, specificity, predictability and accuracy of the three imaging methods.Results Among the 74 patients, 49 (66.2%) patients had positive cervical lymph node metastasis. Of the 374 cervical lymph node levels, 86 levels were confirmed to be positive lymph node metastasis. Sensitivity and specificity of PET-CT was 87.4% and 94.8% when the cut-off value of SUVmax was 1.855. Sensitivity, specificity, positive and negative predictive value and accuracy of PET-CT were higher than those of CT or MRI.Conclusion PET-CT is more effective than CT or MRI in the diagnosis of cervical lymph node metastasis of HNSCC.