FDG uptake in the cervical muscles after neck dissection: imaging features and postoperative natural course on 18F‑FDG‑PET/CT

Yukako Iritani; Hiroki Kato; Yo Kaneko; Takuma Ishihara; Tomohiro Ando; Masaya Kawaguchi; Hirofumi Shibata; Takenori Ogawa; Yoshifumi Noda; Fuminori Hyodo; Masayuki Matsuo

doi:10.1007/s11604-024-01568-6

FDG uptake in the cervical muscles after neck dissection: imaging features and postoperative natural course on ¹⁸F‑FDG‑PET/CT

Jpn J Radiol. 2024 Apr 25. doi: 10.1007/s11604-024-01568-6. Online ahead of print.

Authors

Affiliations

¹ Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
² Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan. kato.hiroki.w4@f.gifu-u.ac.jp.
³ Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan.
⁴ Department of Otolaryngology, Gifu University, Gifu, Japan.
⁵ Center for One Medicine Innovative Translational Research (COMIT), Institute for Advanced Study, Gifu University, Gifu, Japan.

PMID: 38658502
DOI: 10.1007/s11604-024-01568-6

Abstract

Purpose: This study aimed to assess the imaging features and postoperative natural course of ¹⁸F-fluorodeoxyglucose (FDG) uptake in the cervical muscles after neck dissection.

Materials and methods: This study included 83 patients who underwent preoperative and postoperative ¹⁸F-FDG-PET/CT and were diagnosed with head and neck malignancy after neck dissection. Postoperative ¹⁸F-FDG-PET/CT was performed within 5 years after neck dissection. Preoperative and postoperative FDG uptake of the trapezius, sternocleidomastoid, scalene, pectoralis major, and deltoid muscles was visually assessed. Increased postoperative uptake was visually defined as higher postoperative FDG uptake than the preoperative one in the corresponding muscle. The maximum standardized uptake value (SUVmax) was measured in cases with increased postoperative uptakes.

Results: Increased postoperative uptakes were observed in 43 patients (52%). The trapezius (31/83, 37%), sternocleidomastoid (19/83, 23%), and scalene (12/83, 14%) muscles were involved, as opposed to the pectoralis major and deltoid muscles were not. Increased postoperative uptakes were observed on the dissected side in all 43 patients. Significant differences between SUVmax estimated from the mixed-effects model and postoperative months were observed in the trapezius muscle (Coefficient (β) = -0.038; 95% confidence interval (CI): [-0.047, -0.028]; p < 0.001) and sternocleidomastoid muscle (β = -0.015; 95% CI: [-0.029, -0.001]; p = 0.046).

Conclusions: Increased postoperative uptakes in the cervical muscles were observed on the dissected side in approximately half of the patients after neck dissection. The SUVmax in the trapezius and sternocleidomastoid muscles decreased after surgery over time.

Keywords: Cervical muscle; Head and neck cancer; Neck dissection; PET; SUV.