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Distant metastases and synchronous second primary tumors in patients with newly diagnosed oropharyngeal and hypopharyngeal carcinomas: evaluation of 18F-FDG PET and extended-field multi-detector row CT

  • Head and Neck Radiology
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Abstract

Introduction

Patients with oropharyngeal or hypopharyngeal squamous cell carcinoma (SCC) have a high risk of having distant metastases or second primary tumors. We prospectively evaluate the clinical usefulness of 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET), extended-field multi-detector computed tomography (MDCT), and their side-by-side visual correlation for the detection of distant malignancies in these two tumors at presentation.

Materials and methods

A total of 160 patients with SCC of the oropharynx (n = 74) or hypopharynx (n = 86) underwent 18F-FDG PET and extended-field MDCT to detect distant metastases or second primary tumors. Suspected lesions were investigated by means of biopsy, clinical, or imaging follow-up.

Results

Twenty-six (16.3%) of our 160 patients were found to have distant malignancy. Diagnostic yields of 18F-FDG PET and MDCT were 12.5% and 8.1%, respectively. The sensitivity of 18F-FDG PET for detection of distant malignancies was 1.5-fold higher than that of MDCT (76.9% vs. 50.0%, P = 0.039), while its specificity was slightly lower (94.0% vs. 97.8%, P = 0.125). Side-by-side visual correlation of MDCT and 18F-FDG PET improved the sensitivity and specificity up to 80.8% and 98.5%, respectively, leading to alteration of treatment in 13.1% of patients. A significant difference in survival rates between its positive and negative results was observed.

Conclusion

18F-FDG PET and extended-field MDCT had acceptable diagnostic yields for detection of distant malignancies in untreated oropharyngeal and hypopharyngeal SCC. 18F-FDG PET was 1.5-fold more sensitive than MDCT, but had more false-positive findings. Their visual correlation improved the diagnostic accuracy, treatment planning, and prognosis prediction.

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Acknowledgments

This work was supported by the National Science Council, grant no. 94-2314-B-182A-109 and by the Chang Gung Memorial Hospital, grant no. 95-0372B.

Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Molecular Imaging Center and Diagnostic Radiology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, Taoyuan, Taiwan

    Shu-Hang Ng, Sheung-Fat Ko & Shu-Chyn Chin

  2. Department of Nuclear Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University, 5 Fu-Shin St, Kueishan, Taoyuan, 333, Taiwan

    Sheng-Chieh Chan & Tzu-Chen Yen

  3. Department of Otorhinolaryngology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan

    Chun-Ta Liao & Shiang-Fu Huang

  4. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Joseph Tung-Chieh Chang & Chin-Yu Lin

  5. Department of Medical Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan

    Hung-Ming Wang

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  1. Shu-Hang Ng
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Correspondence to Tzu-Chen Yen.

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Ng, SH., Chan, SC., Liao, CT. et al. Distant metastases and synchronous second primary tumors in patients with newly diagnosed oropharyngeal and hypopharyngeal carcinomas: evaluation of 18F-FDG PET and extended-field multi-detector row CT. Neuroradiology 50, 969–979 (2008). https://doi.org/10.1007/s00234-008-0426-2

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