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Positron Emission Tomography in ORL Oncology


Authors: H. Binková 1;  Z. Horáková 1 ;  J. Staníček 2
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF MU a FN u sv. Anny, Brno, přednosta prof. MUDr. R. Kostřica, CSc. 1;  Odd. nukleární medicíny a pozitronové emisní tomografie, Masarykův onkologický ústav, Brno, primář MUDr. K. Bolák 2
Published in: Otorinolaryngol Foniatr, 60, 2011, No. 3, pp. 132-138.
Category: Original Article

Overview

Positron emission tomography is a modern diagnostic method based on monitoring of intravenously applied glucose distribution marked with radionuclide F18.

Increased glucose consumption of malign cells enables their detection, which is unfortunately not exclusively specific for tumor tissues but generally mirrors an increased metabolic cell activity. Better anatomic resolution is provided by PET/CT fusion.

Aims:
We have summarised our 10 year experience with PET diagnostics in patients treated in ENT clinic of St. Anne’s university hospital in Brno. From 2000 to 2009 in 67 oncologic patients 97 PET scanning were undertaken.

Results:
67 of all 97 PET studies were positive, while CT scans were positive in 63 patients. Both studies were in accordance in 77 patients (55 both positive, 22 both negative), which makes 79%. In patients with any discrepancy were radiodiagnostic results compared with histopathology. The estimated CT sensitivity was 89% and specificity 87%, PET sensitivity 91% and specificity 87%. Further we analyzed PET benefit for diagnostics of lymph node metastases persistence after CHRT in organ preserving protocol. In 17 patients CT and PET results were histopathologically confirmed after neck dissection. Sensitivity in this indication was 45% in contrast to high specificity 96%, negative predictive value was 78%.

Conclusion:
PET and CT sensitivity and specificity are mutually comparable and relatively high. Group of patients in our study is non - homogeneous in respect to tumor locality and PET indication. Low sensitivity and negative predictive value for persistent lymph node metastases wouldn’t justify regarding PET as a tool suitable for elimination of neck dissection. All above mentioned facts and its high financial demands are our reasons for the selective and nonstandard PET indication in the oncological patients.

Key words:
PET, CT, head, neck, cancer, specificity, sensitivity.


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