Utility of quantitative 18F‐fluorodeoxyglucose uptake measurement to identify occult tonsillar carcinoma in patients with cervical metastasis of unknown primary tumours: a retrospective case–control study. (19th February 2013)

• Record Type: Journal Article
• Authors: Lee, H.J.; Kim, J.S.; Roh, J.‐L.; Lee, J.H.; Cho, K.‐J.; Park, G.C.; Choi, S.‐H.; Nam, S.Y.; Kim, S.Y.
• Is Part Of: Clinical otolaryngology. Volume 38:Number 1(2013:Feb.)
• Page Start: 30
• Page End: 38
• Publication Date: 2013-02-19
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1111/coa.12055
• Languages: English
• ISSNs: 1749-4478

Abstract

Abstract : Objectives: Due to relatively high 18 F‐fluorodeoxyglucose accumulation in the tonsillar region, the detection of occult tonsillar cancers by 18 F‐fluorodeoxyglucose positron emission tomography/computerised tomography remains controversial. Therefore, we assessed the usefulness of quantitative tonsil 18 F‐fluorodeoxyglucose uptake in identifying occult tonsillar squamous cell carcinoma. Design: A case–control study of retrospective cohorts. Setting: University Teaching Hospital. Main outcome measures: We assessed all patients diagnosed with tonsillar cancers or cervical lymph node metastasis of unknown primary tumours between 2005 and 2010 who underwent 18 F‐fluorodeoxyglucose positron emission tomography/computerised tomography. The subjects were grouped into A (apparent early pT‐stage tonsillar squamous cell carcinoma; n = 27), B (occult tonsillar squamous cell carcinoma, primary tumours were found by surgery; n = 21), C (cervical metastasis of unknown primary tumour, primary tumours were not found by surgery and for follow‐up; n = 16) and D (33 healthy controls). Tonsillar maximum standardised uptake values were bilaterally measured and compared between groups. Results: The sensitivity and specificity of qualitative assessment of 18 F‐fluorodeoxyglucose positron emission tomography/computerised tomography for detection of occult tonsillar cancers were 67% and 69%, respectively. Mean maximum standardised uptake values of tonsils with cancer were 11.19 ± 5.46 in group A and 8.12 ± 4.52 in group B, which were significantly higher than that of group C (4.62 ± 1.76) or group D (4.57 ± 1.62) ( P < 0.01). The mean maximum standardised uptake value differences of groups A (6.35) and B (3.11) were significantly greater than those of groups C (0.32) and D (0.59) ( P < 0.01). Similarly, the mean maximum standardised uptake value ratios of groups A (2.47) and B (1.73) were significantly greater than those of groups C (1.06) and D (1.16) ( P < 0.01). Conclusion: 18 F‐fluorodeoxyglucose positron emission tomography/computerised tomography with tonsil SUVmax measurement is useful to identify occult tonsillar squamous cell carcinoma.