Preoperative predictive model of cervical lymph node metastasis combining fluorine-18 fluorodeoxyglucose positron-emission tomography/computerized tomography findings and clinical factors in patients with oral or oropharyngeal squamous cell carcinoma

Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Feb;113(2):274-82. doi: 10.1016/j.tripleo.2011.08.022. Epub 2012 Jan 20.

Abstract

Objective: This study aimed to construct a preoperative predictive model of cervical lymph node metastasis using fluorine-18 fluorodeoxyglucose positron-emission tomography/computerized tomography ((18)F-FDG PET/CT) findings in patients with oral or oropharyngeal squamous cell carcinoma (SCC).

Study design: Forty-nine such patients undergoing preoperative (18)F-FDG PET/CT and neck dissection or lymph node biopsy were enrolled. Retrospective comparisons with spatial correlation between PET/CT and the anatomical sites based on histopathological examinations of surgical specimens were performed. We calculated a logistic regression model, including the SUVmax-related variable.

Results: When using the optimal cutoff point criterion of probabilities calculated from the model that included either clinical factors and delayed-phase SUVmax ≥0.087 or clinical factors and maximum standardized uptake (SUV) increasing rate (SUV-IR) ≥ 0.100, it significantly increased the sensitivity, specificity, and accuracy (87.5%, 65.7%, and 75.2%, respectively).

Conclusions: The use of predictive models that include clinical factors and delayed-phase SUVmax and SUV-IR improve preoperative nodal diagnosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Anatomy, Regional
  • Biopsy
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / secondary
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Linear Models
  • Lymph Nodes / diagnostic imaging*
  • Lymphatic Metastasis / diagnostic imaging
  • Male
  • Middle Aged
  • Mouth Neoplasms / diagnostic imaging*
  • Mouth Neoplasms / pathology
  • Neck Dissection / methods*
  • Oropharyngeal Neoplasms / diagnostic imaging*
  • Oropharyngeal Neoplasms / pathology
  • Predictive Value of Tests
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Retrospective Studies

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18