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KMID : 0880420090100010001
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Korean Journal of Radiology
2009 Volume.10 No. 1 p.1 ~ p.7
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The Clinical Usefulness of 18F-FDG PET/CT for the Evaluation of Lymph Node Metastasis in Periorbital Malignancies
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Baek Chung-Hwan
Chung Man-Ki
Jeong Han-Sin
Son Young-Ik
Choi Jee-Sun
Kim Yoon-Duck
Choi Joon-Young
Kim Hyung-Jin
Ko Young-Hyeh
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Abstract
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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.
Result : 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.
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KEYWORD
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18F-FDG, PET/CT, Computed tomography (CT) scans, Lymphatic Metastasis, Eyelid Neoplasm
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