18F-FDG PET/CT for the detection of primary malignancy in patients with cervical lymph node metastatses from unknown origin / 中华核医学与分子影像杂志

ABSTRACT

Objective To investigate the value of 18F-FDG PET/CT for the detection of primary malignancy in patients with cervical lymph node metastases from unknown origin.Methods Seventy-eight patients (48 males,30 females,average age (56.4± 14.7) years) who were diagnosed as cervical lymph node metastases from unknown origin by fine needle aspiration underwent 18F-FDG PET/CT from 2007 to 2012.ROI was drawn with SUVm~ calculated.The distribution of the lymph nodes was classified according to the standard levels Ⅰ to Ⅵ,as well as the retropharyngeal and supraclavicular stations.The short axis of lymph node was defined as the lesion size.The final diagnosis was confirmed by pathology and clinical follow-up.Data collection and interpretation included identification of primary malignancy,pathologic types of primary tumors,distribution,size and SUVmax of the metastatic lymph nodes.One-way analysis of variance and linear correlation analysis were used for data analysis.Results In 78 subjects,75 were diagnosed as having malignant and 3 as benign lymph nodes by excisional biopsy.18F-FDG PET/CT detected primary malignancy in 56 cases (71.8％,56/78).In these 56 cases,57.1％(32/56) had head and neck cancer with metastatic lymph nodes mainly distributed in levels Ⅱ,Ⅲ and Ⅳ (90.6％,29/32).The remaining 24/56 (42.9％) patients had primary malignancy of the trunk with metastatic lymph nodes primarily involving supraclavicular fossa (95.8％,23/24).There was no statistical difference in size and SUVmax of lymph node among different primary locations or pathological types (F=0.037-2.413,all P＞0.05).Conclusion 18FFDG PET/CT may play an important role in the detection of primary cancers for patients with metastatic cervical lymph nodes from unknown origin.