Radiation Oncology Journal

  • 제30권4호
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  • Pages.173-181
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  • 2012
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  • 2234-1900(pISSN)
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  • 2234-3156(eISSN)
대한방사선종양학회 (The Korean Society for Radiation Oncology)
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Prognostic value of $^{18}F$-fluorodeoxyglucose positron emission tomography, computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with pathologically positive neck lymph node

  • Jwa, Eunjin (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang-Wook (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jae-Seung (Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Jin Hong (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Su Ssan (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Young Seok (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yoon, Sang Min (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Song, Si Yeol (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jong Hoon (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Eun Kyung (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ahn, Seung Do (Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine)
  • 투고 : 2012.09.06
  • 심사 : 2012.10.18
  • 발행 : 2012.12.30
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초록

Purpose: To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with $^{18}F$-fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. Materials and Methods: In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative $^{18}F$-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of $^{18}F$-FDG PET and CT/MRI. Results: Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by $^{18}F$-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by $^{18}F$-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value ($SUV_{max}$) on clinical outcomes. Notably, $SUV_{max}$ showed significant correlation with tumor size in LN (p < 0.01, $R^2$ = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p < 0.05, $R^2$ = 0.37 and p < 0.01, $R^2$ = 0.48, respectively). Conclusion: $^{18}F$-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of $SUV_{max}$.

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