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18F-FDG PET/CT for Detecting Nodal Metastases in Patients with Oral Cancer Staged N0 by Clinical Examination and CT/MRI

Heiko Schöder1, Diane L. Carlson2, Dennis H. Kraus3, Hilda E. Stambuk1, Mithat Gönen4, Yusuf E. Erdi5, Henry W.D. Yeung1, Andrew G. Huvos2, Jatin P. Shah3, Steven M. Larson1 and Richard J. Wong3

1 Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York; 2 Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; 3 Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York; 4 Department of Biostatistics and Epidemiology, Memorial Sloan-Kettering Cancer Center, New York, New York; and 5 Department of Physics, Memorial Sloan-Kettering Cancer Center, New York, New York


Figure 1
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  		FIGURE 1.  Schema of neck lymph node levels used for surgical and radiologic assessment.

 

Figure 2
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  		FIGURE 2.  Flow chart shows distribution of findings.

 

Figure 3
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  		FIGURE 3.  TP PET/CT in 53-y-old man with cancer of left oral tongue. Primary tumor is not well seen on noncontrast CT (A) but is clearly delineated on PET (B) and PET/CT fusion (C) images. (D) CT shows borderline lymph node in right level II neck but no abnormality in left neck. However, PET shows moderate 18F-FDG uptake (SUV, 4.4) in left neck (E), which on fusion images clearly localizes to a small left level II node (F).

 

Figure 4
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  		FIGURE 4.  FP PET/CT in 50-y-old man with cancer of right oral tongue. Primary tumor is not well seen on noncontrast CT (A) but is clearly delineated on PET (B) and PET/CT fusion (C) images. (D) CT shows small lymph node in right neck level III, which shows moderate 18F-FDG uptake (SUV, 4.6) on PET image (E). Fusion image shows 18F-FDG uptake clearly within this node (F). Histopathology revealed abundant lymphocytes but no metastatic deposit.

 




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