Head and neck
Published: 2023-05-23
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Role of 18F-FDG PET/CT in evaluating lymph node status in patients with head and neck squamous cell carcinoma

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy; C. Bianchini and M. Caracciolo contributed equally to this work.
https://orcid.org/0000-0002-5115-6107
Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy; C. Bianchini and M. Caracciolo contributed equally to this work.
https://orcid.org/0000-0003-4129-8328
Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
https://orcid.org/0000-0002-3007-3898
ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
https://orcid.org/0000-0003-3455-2295
ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
Oncological Medical and Specialists Department, Oncology Unit, University Hospital of Ferrara, Ferrara, Italy
Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
https://orcid.org/0000-0003-1985-6311
Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
https://orcid.org/0000-0002-5117-804X
Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
https://orcid.org/0000-0002-1490-0718
ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy
Nuclear Medicine Unit, Oncology and Haematology Department, University Hospital of Modena, Modena, Italy
https://orcid.org/0000-0002-9222-8752
Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy
squamous cell carcinoma 18F-FDG PET/CT lymph node metastasis standardized uptake value

Abstract

Objective. The presence of cervical lymph node metastases (CLNM) at diagnosis is one of the most relevant negative prognostic factors in patients with head and neck squamous cell carcinoma (HNSCC). The aim of this study was to analyse 2-deoxy-2[18F]fluoro-D-glucose (FDG) PET/CT findings for the identification of primary tumours and CLNM in a sample of patients affected by HNSCC. Moreover, a maximum standardised uptake value (SUVmax) threshold for the detection of CLNM was estimated. Clinical variables (i.e. smoking and alcohol habits), and tumour features (i.e. EBV and HPV positivity) were also evaluated in relation to FDG PET/CT findings.
Methods. We retrospectively analysed patients who underwent FDG PET/CT for HNSCC staging between 2015-2020 at the University Hospital of Ferrara. All patients had cytological or histological confirmation of suspected cervical lymph nodes.
Results. In total, 65 patients were enrolled (53 males, 12 females, median age 65.7 years). CLNM of patients with smoking habit had significantly higher SUVmax values than those of patients with previous smoking habit and non-smokers (p = 0.04). p16 positive HNSCC demonstrated a trend for higher SUVmax values on CLNM, in comparison to p16 negative tumours (p = 0.089). ROC curve analysis identified 5.8 as the best cut-off value of SUVmax for the detection of CLNM (AUC = 0.62, sensitivity 71.4% and specificity 72.7%).
Conclusions. FDG PET/CT is a useful tool to evaluate CLNM in patients with HNSCC, particularly in those with smoking habit and p16 positive disease. A SUVmax cut-off of 5.8, combined with the use of conventional radiological investigations, may represent a useful tool in the identification of CLNM.

Affiliations

Chiara Bianchini

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy; C. Bianchini and M. Caracciolo contributed equally to this work.

Matteo Caracciolo

Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy; C. Bianchini and M. Caracciolo contributed equally to this work.

Luca Urso

Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy

Andrea Ciorba

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy

Anna Bonsembiante

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy

Andrea Migliorelli

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy

Virginia Corazzi

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy

Ilaria Carandina

Oncological Medical and Specialists Department, Oncology Unit, University Hospital of Ferrara, Ferrara, Italy

Naima Ortolan

Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy

Corrado Cittanti

Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy

Licia Uccelli

Translational Medicine Department, Ferrara University, Ferrara, Italy; Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy

Stefano Pelucchi

ENT and Audiology Department, University Hospital of Ferrara, Ferrara, Italy

Stefano Panareo

Nuclear Medicine Unit, Oncology and Haematology Department, University Hospital of Modena, Modena, Italy

Mirco Bartolomei

Nuclear Medicine Unit, Oncological Medical and Specialists Department, University Hospital of Ferrara, Ferrara, Italy

Copyright

© Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale , 2023

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