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KMID : 0356820180340010021
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Korean Journal of Head & Neck Oncology
2018 Volume.34 No. 1 p.21 ~ p.27
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A correlation between comprehensive neck dissection and increased uptake around the sternoclavicular joint on post-operative 18F-FDG PET/CT
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Oh So-Won
Lee Doh-Young
Kim Bo-Hae
Kim Kwang-Hyun
Kim Yu-Kyeong
Jung Young-Ho
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Abstract
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Background/Objectives: This study aimed to evaluate the changes of uptake around the sternoclavicular joint (SCJ) according to 18F-FDG PET images in patients with head and neck cancer who underwent neck dissection.
Materials & Methods: Retrospectively, the medical records of patients who received selective or comprehensive neck dissection were reviewed. Preoperative and 1-year postoperative 18F-FDG PET images, if available, were analyzed by nuclear medicine physicians in both qualitative and quantitative manners. Correlation between the changes of uptake around SCJ and perioperative data were statistically analyzed.
Results: Thirty-seven patients satisfying the inclusion criteria were enrolled. Seven patients with increased uptake around SCJ on 1-year postoperative 18F-FDG PET showed a correlation with radical or comprehensive neck dissection, accessory nerve sacrifice, and high postoperative SUVmax. When 20 patients with increased uptake around SCJ according to quantitative measurement were compared with other patients without increased uptake, no parameter was significantly different, except postoperative SUVmax. Bivariate logistic regression analysis revealed that the clinical symptom (shoulder or sternal pain) was significantly correlated with the extent of neck dissection (OR 0.227, CI 0.053-0.966, p=0.045) and spinal accessory nerve sacrifice (OR 13.500, CI 1.189-153.331, p=0.036).
Conclusions: Increased uptake around SCJ on 1-year postoperative 18 F-FDG PET was correlated with either the radical or comprehensive procedure, as well as with accessory nerve sacrifice. This suggests that subjective analysis of 18F-FDG PET can be used to detect subclinical shoulder instability.
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KEYWORD
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Sternoclavicular joint, Neck dissection, Accessory nerve, Positron-Emission Tomography, Head and neck neoplasm
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