1.The Clinical Usefulness of 18F-FDG PET/CT for the Evaluation of Lymph Node Metastasis in Periorbital Malignancies.
Chung Hwan BAEK ; Man Ki CHUNG ; Han Sin JEONG ; Young Ik SON ; Jeesun CHOI ; Yoon Duck KIM ; Joon Young CHOI ; Hyung Jin KIM ; Young Hyeh KO
Korean Journal of Radiology 2009;10(1):1-7
OBJECTIVE: The aim of this study was to assess the clinical role of 18F-FDG PET/CT for the evaluation of lymph node metastasis in periorbital malignancies, compared with CT alone. MATERIALS AND METHODS: We analyzed eighteen PET/CT and CT scans in 15 patients with biopsy-proven periorbital malignancies. We compared the diagnostic capabilities of PET/CT and CT with regard to nodal metastasis by level-by-level analysis and by N staging prediction. The reference standards were surgical pathology (n = 7) from dissected lymph node specimens and the results from radiological follow-up (n = 11, mean 20.5 months; range 10-52 months). Moreover, any changes in patient care as prompted by PET/CT were recorded and compared with treatment planning for CT alone. RESULTS: PET/CT had a sensitivity of 100%, while CT had a sensitivity of 57% (p = 0.03) for nodal metastasis by level-by-level analysis. PET/CT had a specificity of 97%, positive predictive value of 93%, negative predictive value of 100%, and diagnostic accuracy of 98%, while the CT values for these same parameters were 97%, 89%, 82%, and 84%, respectively. PET/CT correctly predicted N staging with an accuracy of 100%, while CT was only 83% accurate (p = 0.01). Regarding the impact on patient care, the extent of surgery for regional lymph nodes and the treatment decision were modified by PET/CT in 39% of patients. CONCLUSION: PET/CT could provide useful information in the management of regional lymph node metastases in patients with periorbital malignancies.
Adult
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Aged
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Contrast Media
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Eye Neoplasms/pathology/*secondary
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Eyelid Neoplasms/pathology/secondary
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Female
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Fluorodeoxyglucose F18/*diagnostic use
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Humans
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Iohexol/analogs & derivatives/diagnostic use
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Lacrimal Apparatus Diseases/pathology
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Lymphatic Metastasis/diagnosis
;
Male
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Middle Aged
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*Positron-Emission Tomography
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Radiopharmaceuticals/*diagnostic use
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Sensitivity and Specificity
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*Tomography, X-Ray Computed/methods