Aim: Aim of the study was to evaluate [F-18] FDG imaging of head and neck tumors using a Hybrid-PET device of the 2nd or 3rd generation. Examinations were compared to dedicated PET and Spiral-CT. Methods: 54 patients suffering from head and neck tumors were examined using dedicated PET and Hybrid-PET after injection of 185-350 MBq [F-18] FDG. Examinations were carried out on the dedicated PET first followed by a scan on the Hybrid-PET. Dedicated PET was acquired in 3D mode, Hybrid-PET was performed in list mode using an axial filter. Reconstruction of data was performed itera-tively on both, dedicated PET and Hybrid-PET. All patients received a CT scan in multislice technique. All finding have been verified by the goldstandard histology or in case of negative histology by follow up. Results: Using dedicated PET the primary or recurrent lesion was correctly diagnosed in 47/48 patients, using Hybrid-PET in 46/ 48 patients and using CT in 25/48 patients. Metastatic disease in cervical lymph nodes was diagnosed in 17/ 18 patients with dedicated PET, in 16/18 patients with Hybrid-PET and in 15/18 with CT. False positive results with regard to lymph node metastasis were seen with one patient for dedicated PET and Hybrid-PET, respectively, and with 18 patients for CT. In a total of 11 patients unknown metastastic lesions were seen with dedicated PET and with Hybrid-PET elsewhere in the body. Additional malignant disease other than the head and neck tumor was found in 4 patients. Conclusion: Using Hybrid-PET for [F-18] FDG imaging reveals a loss of sensitivity and specificity of about 1-5% as compared to dedicated PET in head and neck tumors. [F-18] FDG PET with both, dedicated PET and Hybrid-PET is superior to CT in the diagnosis of primary or recurrent lesions as well as in the assessment of lymph node involvement.
Zusammenfassung
Ziel: Erhebung des Stellenwertes von [F-18] FDG-Unter-suchungen mit einem Hybrid-PET Gerät im Vergleich zu Ring-PET und morphologischer Bildgebung (Spiral-CT) bei Patienten mit Kopf-Hals-Tumoren. Methoden: 54 Patienten mit Kopf-Hals-Tumoren wurden vergleichend mit Ring-PET und Hybrid-PET nach Injektion von 185-350 MBq [F-18] FDG untersucht. Die Aufnahmen wurden zuerst an einem Ring-PET und dann an einem Hybrid-PET durchgeführt. Die Ring-PET-Akquisition erfolgte im 3 D-Modus, die Hybiid-PET-Aufnahmen im List-Mode unter Verwendung des axialen Filters. Sämtliche Daten wurden iterativ rekonstruiert. Alle Patienten wurden zusätzlich in Multislice-Spiral-Technlk computertomo-graphisch untersucht. Sämtliche Bewertungen beruhen auf dem Goldstandard Histologie bzw. dem Verlauf bei negativer Histologie. Ergebnisse: Mit Ring-PET wurde der Primär-/Rezidivtumor bei 47/48 Patienten richtigpositiv diagnostiziert, mit Hybrid-PET bei 46/48 und mit CT bei 25/48 Patienten. Zervikale Lymphknotenmetastasen wurden bei 17/18 Patienten mit Ring-PET und bei 16/18 mit Hybrid-PET richtig-positiv diagnostiziert, während die CT bei 15/18 Patienten richtig-positive Befunde erhob. Falsch-positive Befunde hinsichtlich der Lymphknotendiagnostik lieferten Ring- und Hybrid-PET bei jeweils einem Patienten, die CT bei 18 Patienten. Bei insgesamt elf Patienten wurden bislang unbekannte Fernmetastasen mit Ring- und Hybrid-PET nachgewiesen. Zweittumoren wurden mittels Ring- und Hybrid-PET bei vier Patienten diagnostiziert. Schlussfolgerungen: Bei Messung des [F-18] FDG-Uptake mit einem Hybrid-PET muss im Vergleich zu Ring-PET-Geräten mit geringen Verlusten hinsichtlich Sensitivität und Spezifität in der Größenordnung von 1-5% gerechnet werden. Die Methode ist mit beiden Geräten der CT in der Diagnostik der Primär-/Rezidivtumoren und von zervikalen Lymphknotenmetastasen überlegen.
Keywords
Hybrid-PET -
dedicated PET -
[F-18] FDG -
coincidence imaging -
head and neck tumors
1
Abdel-Nabi H,
Spaulding MB,
Behar P,
Nguyen A,
Simpson G,
Gona J.
Value of PET-FDG imaging in the pre-operative work-up of patients with head and neck carcinomas. J Nucl Med 1996; 37: 136P.
3
Anzai Y,
Carroll WR,
Quint DJ,
Bradford CR,
Minoshima S,
Wolf GT,
Wahl RL.
Recurrence of head and neck cancer after surgery or irradiation: prospective comparison of 2-deoxy-2[F-18]-fluoro-D-glucose PET and MR imgaging diagnosis. Radiology 1996; 200: 135-41.
4
Bailet JW,
Abemayor E,
Jabour BA,
Hawkins RA,
Höh C,
Ward PH.
Positron emission tomography: a new, precise imaging modality for detection of primary head and neck tumours and assessment of cervical adenopathy. Laryngoscope 1992; 102: 281-8.
5
Braams JW,
Pruim J,
Freiing NJM,
Nikkeis PG,
Roodenburg JL,
Boering G,
Vaalburg W,
Vermey A.
Detection of lymph mode metastases of squamouscell cancer of the head and neck with FDG-PET an MRI. J Nucl Med 1995; 36: 211-6.
6
Braams JW,
Pruim J,
Kole AC,
Nikkeis PG,
Vaalburg W,
Vermey A,
Roodenburg JL.
Detection of unknown primary head and neck tumours by positron emissions tomography. Int J Oral Maxillofac Surg 1997; 26: 112-5.
7
Bronstein AD,
Nyberg DA,
Schwartz AN,
Schumann WP,
Griffin BR.
Soft tissue changes after head and neck radiation: CT findings. Am J Neurol Rad 1989; 10: 171-5.
10
Haberkorn U,
Strauss LG,
Reisser C,
Haag D,
Dimitrakopoulou A,
Ziegler S,
Oberdorfer F,
Rudat V,
van Kaick G.
Glucose uptake, perfusion and cell proliferation in head and neck tumors: relation of positron emission tomography to flow cytometry. J Nucl Med 1991; 32: 1548-55.
11
Harnsberger H,
Mancuso A,
Muraki A,
Parkin J.
The upper aerodigestive tract and neck: CT evaluation of recurrent tumors. Radiology 1983; 149: 403-9.
12
Hillsamer PJ,
Schüller DE,
McGhee RB,
Chakeres D,
Young DC.
Improving diagnostic accuracy of cervical metastases with computed tomography and magnetic resonance imaging. Arch Otolaryngol Head Neck Surg 1990; 116: 1297-301.
13
Jabour BA,
Choi Y,
Höh CK,
Rege SD,
Soong JC,
Lufkin RB,
Hanafee WN,
Maddahi J,
Chaiken L,
Bailet J.
Extracranial head and neck: PET imaging with 2-[F-18]fluoro-2-deoxy-D-glucose and MR imaging correlation. Radiology 1993; 186: 27-35.
15
Jungehülsing M,
Scheidhauer K,
Damm M,
Pietrzyk U,
Eckel H,
Schicha H,
Stennert E.
2[F]-fluoro-2-deoxy-D-glucose positron emission tomography is a sensitive tool for the detection of occult. Otolaryngol Head Neck Surg 2000; 123: 294-301.
16
Lapela M,
Grenman R,
Kurki T,
Joensuu H,
Leskinen S,
Lindholm P,
Haaparanta M,
Ruotsalainen U,
Minn H.
Head and neck cancer: detection of recurrence with PET and 2-[F18] fluoro-2-deoxy-D-glucose. Radiology 1995; 197: 205-11.
17
Laubenbacher C,
Saumweber D,
Wagner-Manslau C,
Kau RJ,
Herz M,
Avril N,
Ziegler S,
Kruschke C,
Arnold W,
Schwaiger M.
Comparison of fluorine-18-fluorodeoxyglucose PET, MRI and endoscopy for staging head and neck squamous-cell carcinomas. J Nucl Med 1995; 36: 1747-57.
18
Mc Guirt WF,
Williams DW,
Keyes JW,
Greven KM,
Watson NE,
Geisinger KR,
Cappellari JO.
A comparative diagnostic study of head and neck nodal metastases using positron emission tomography. Laryngoscope 1995; 105: 373-5.
19
Minn H,
Clavo AC,
Grenman R,
Wahl RL.
In vitro comparison of cell proliferation kinetics and uptake of tritiated fluorodeoxyglucose and L-methionine in squamous-cell carcinoma of the head and neck. J Nucl Med 1995; 36: 252-8.
20
Minn H,
Joensuu H,
Ahonen A,
Klemi P.
Fluorodeoxyglucose imaging: a method to assess the proliferative activity of human cancer in vivo. Cancer 1988; 61: 1776-81.
21
Nowak B,
Di Martino E,
Jänicke S,
Cremerius U,
Adam G,
Zimny M,
Reinartz P,
Büll U.
Diagnostic evaluation of malignant head and neck cancer by F-18-FDG PET compared to CT/MRI. Nuklearmedizin 1999; 38: 312-8.
22
Pfluger T,
Vollmar C,
Wismuller A,
Dresel S,
Berger F,
Suntheim P,
Leinsinger G,
Hahn K.
Quantitative comparison of automatic and interactive methods for MRI-SPECT image registration of the brain based on 3-dimensio-nal calculation of error. J Nucl Med 2000; 41: 1823-9.
23
Pichler R,
Maschek W,
Hatzl-Griesenhofer M,
Huber H,
Wimmer G,
Wahl G,
Fridrik M.
Klinische Wertigkeit der Befunde von FDG-PET mittels Koinzidenz-Gammakamera beim Staging and Restaging maligner Lymphome ein Vergleich zu konventioneller Diagnostik. Nuklearmedizin 2000; 39: 166-73.
24
Quetz JU,
Rohr S,
Hoffmann P,
Wustrow J,
Mertens J.
B-image sonography in lymph node Staging of the head and neck area. A comparison with palpation, computerized and magnetic resonance tomography. HNO 1991; 39: 61-3.
26
Stokkel MPM,
ten Broek FW,
van Rijk PP.
Preoperative assessment of cervical lymph nodes in head and neck cancer with fluorine-18 fluorodeoxyglucose using a dual-head coincidence camera: a pilot study. Eur J Nucl Med 1999; 26: 499-503.
27
Stokkel MPM,
Terhaard CHJ,
Hordijk GJ,
van Rijk PP.
The detection of local recurrent head and neck cancer with fluorine-18 fluorodeoxyglucose dual-head positron emission tomography. Eur J Nucl Med 1999; 26: 767-73.
28
Stokkel MPM,
van Isselt JW,
Hoekstra A,
van Rijk PP.
Lesions of 4 mm and 5 mm detected with 18F-FDG using a dual head coincidence camera [abstract]. Eur J Nucl Med 1998; 25: 1032.
29
van den Brekel MWM,
Catelijns JA,
Croll GA,
Stel HV,
Valk J,
van der Waal I,
Golding RP,
Meyer CJ,
Snow GB.
Magnetic resonance imaging versus palpation of cervical lymph node metastases. Arch Otolaryngol Head Neck Surg 1991; 117: 666-73.
30
van den Brekel MWM,
Stel HV,
Castelijns JA,
Nauta JJ,
van der Waal I,
Valk J,
Meyer CJ,
Snow GB.
Cervical lymph node metastasis: assessment of radiologic criteria. Radiology 1990; 177: 379-84.
31
Zimny M,
Kaiser H-J,
Cremerius U,
Sabri O,
Schreckenberger M,
Reinartz P,
Büll U.
F-18-FDG-Positronen-Emissions-Tomographie bei onkologischen Patienten: Doppelkopf-Koinzi-denz-Gammakamera versus Vollring-PET. Nukearmedizin 1999; 38: 108-14.
