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Abstract The aim of this study was to evaluate the ability of pretreatment 90-min 18F- fluorodeoxyglucose positron emission tomography/computed tomography (

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Abstract

The aim of this study was to evaluate the ability of pretreatment 90-min 18F-

fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG

PET/CT) to predict the extranodular spread of lymph node metastases in oral squamous

cell carcinoma. We retrospectively reviewed the cases of 56 patients who underwent

pretreatment 18F-FDG PET/CT and surgery with neck dissection. Maximum

standardized uptake value, metabolic tumor volume, and total lesion glycolysis were

measured for the 56 primary sites and maximum standardized uptake value was

measured for 115 lymph node levels. Extranodular spread was present at 9 lymph node

levels in 7 patients. Significant differences were found in metabolic tumor volume and

total lesion glycolysis of the primary site, and in lymph node maximum standardized

uptake value, between patients with and without extranodular spread (p<0.05).

Combining primary site total lesion glycolysis and lymph node maximum standardized

uptake volume at their respective optimal cutoffs, the sensitivity, specificity, and

accuracy for predicting extranodular spread were 89%, 92%, and 92%, respectively.

Pretreatment 18F-FDG PET/CT is useful for predicting extranodular spread in patients

with oral squamous cell carcinoma. The combined use of primary site total lesion

glycolysis and lymph node maximum standardized uptake value showed greater

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predictive value than either predictor singly.

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