18F-FDG PET/CT Combined with MRI for Detecting Occult Lymph Node Metastases in Head and Neck Squamous Cell Carcinoma
10.3969/j.issn.1005-5185.2025.09.013
- VernacularTitle:18F-FDG PET/CT结合MRI检测头颈部鳞状细胞癌隐匿性淋巴结转移的价值
- Author:
Zhongming WU
1
;
Ruizhi ZHANG
;
Bolun ZHANG
;
Shuntao LIU
;
Weiqi WANG
Author Information
1. 西安医学院第三附属医院口腔病院,陕西 西安 710068
- Publication Type:Journal Article
- Keywords:
Head and neck neoplasms;
Carcinoma,squamous cell;
Positron emission tomography computed tomography;
Fluorodeoxyglucose F18;
Magnetic resonance imaging;
Diffusion-weighted imaging;
Lymphatic metastasis;
Prognosis
- From:
Chinese Journal of Medical Imaging
2025;33(9):980-984
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the value of 18F-FDG PET/CT combined with MRI for detecting occult lymph node metastases in head and neck squamous cell carcinoma(HNSCC).Materials and Methods Eighteen patients with clinically node-negative,pathologically confirmed HNSCC were retrospectively enrolled from the Third Affiliated Hospital of Air Force Medical University from January 2022 to December 2023.All patients underwent preoperative 18F-FDG PET/CT and MRI,including 3D BRAVO high-resolution structural imaging,T2WI and diffusion-weighted imaging.Two nuclear medicine physicians qualitatively and semi-quantitatively assessed cervical lymph nodes for glucose metabolism and apparent diffusion coefficient(ADC)abnormalities.Using postoperative pathology as the gold standard,the diagnostic performance of PET,ADC and their combination for detecting occult metastases was compared.Results Among 54 dissected lymph nodes from 18 patients,12(22.2%)were pathologically confirmed as metastatic.Of 7 false-negative lymph nodes on diffusion weighted imaging,18F-FDG PET/CT correctly identified 4 as positive.18F-FDG PET/CT showed 6 false negatives and 6 false positives.The accuracies of 18F-FDG PET/CT and MRI for detecting occult metastases were 77.8%and 55.6%,respectively,while their combination achieved 91.1%accuracy(41/45).Metastatic lymph nodes exhibited higher maximum standardized uptake values(3.53±0.26 vs.2.71±0.14;t=3.17,P=0.008)and lower ADC values(0.91×10-3 mm2/s vs.1.07×10-3 mm2/s;t=4.15,P=0.001)compared with inflammatory nodes.Conclusion 18F-FDG PET/CT combined with diffusion weighted imaging improves detection of occult lymph node metastases in HNSCC and may guide surgical management.
