구강 및 구인두 편평상피암종의 림프절 전이에 대한 PET-CT 영상의 유용성

Utility of FDG PET-CT Scans on Nodal Staging of Squamous Cell Carcinoma in the Oral Cavity and Oropharynx

Objectives ：We evaluated the use of FDG PET/CT for the identification of cervical nodal metastases of SCC of the oral cavity and oropharynx with histological correlation. Material and Methods ：We reviewed 46 medical records, from January 2004 to July 2007, of patients who underwent FDG PET/CT and CT/MRI for SCC of the oral cavity and oropharynx before surgery. We recorded the lymph node metastases according to the neck level affected and the system used for the imaging-based nodal classification. Results ：The FDG PET/ CT had a sensitivity of 75.6% and a specificity of 96.7%；it had a higher sensitivity than the CT/MRI for identi-fication of cervical metastases on the side of the neck(26/28 vs. 20/28, p=0.031) and at each of the cervical levels(34/45 vs. 26/45, p=0.008). There was a significant difference in the SUV max between the benign and malignant cervical lymph nodes(3.31±3.23 vs. 4.22±2.57, p=0.028). The receiver-operating-characteristic (ROC) curve analysis for differentiating the benign from the malignant cervical lymph nodes, showed that the area under the curve(AUC) of the FDG PET/CT was 0.775. The cut-off value for the SUV max was 2.23 based on the ROC curve. There was a significant correlation between the SUV max and the size of the cervical lymph nodes(Spearman r=0.353, p=0.048). Conclusion ：FDG PET/CT images were more accurate than the CT/MRI images. In addition, the SUV max cut-off values were important for evaluating cervical the cervical nodes in the patients with SCC of the oral cavity and oropharynx.