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The added value of 18F-fluorodeoxyglucose positron emission tomography computed tomography in patients with neck lymph node metastases from an unknown primary malignancy

Published online by Cambridge University Press:  07 August 2013

S J B Prowse ,
R Shaw ,
D Ganeshan ,
P M Prowse ,
R Hanlon ,
H Lewis-Jones  and
H Wieshmann
S J B Prowse*
Affiliation:
Department of Radiology, University Hospital Aintree, Liverpool, UK
R Shaw
Affiliation:
Department of Head and Neck Surgery, University Hospital Aintree, Liverpool, UK Department of Molecular and Clinical Cancer Medicine and Liverpool Cancer Research UK Centre, University of Liverpool, UK
D Ganeshan
Affiliation:
Department of Radiology, University Hospital Aintree, Liverpool, UK
P M Prowse
Affiliation:
Department of Head and Neck Surgery, University Hospital Aintree, Liverpool, UK
R Hanlon
Affiliation:
Department of Radiology, University Hospital Aintree, Liverpool, UK
H Lewis-Jones
Affiliation:
Department of Radiology, University Hospital Aintree, Liverpool, UK
H Wieshmann
Affiliation:
Department of Radiology, University Hospital Aintree, Liverpool, UK
*
Address for correspondence: Dr S J B Prowse, Radiology Department, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK Fax: +44 151 529 3306 E-mail: sjbprowse@gmail.com
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Abstract

Background:

The search for a primary malignancy in patients with a metastatic cervical lymph node is challenging yet ultimately of utmost clinical importance. This study evaluated the efficacy of positron emission tomography computed tomography in detecting the occult primary, within the context of a tertiary referral centre head and neck cancer multidisciplinary team tumour board meeting.

Methods:

Thirty-two patients (23 men and 9 women; mean and median age, 61 years) with a metastatic cervical lymph node of unknown primary origin, after clinical examination and magnetic resonance imaging, underwent positron emission tomography computed tomography.

Results:

The primary tumour detection rate was 50 per cent (16/32). Positron emission tomography computed tomography had a sensitivity of 94 per cent (16/17) and a specificity of 67 per cent (10/15). Combining these results with those of 10 earlier studies of similar patients gave an overall detection rate of 37 per cent.

Conclusion:

Positron emission tomography computed tomography has become an important imaging modality. To date, it has the highest primary tumour detection rate, for head and neck cancer patients presenting with cervical lymph node metastases from an unknown primary.

Keywords

Positron-Emission Tomography and Computed TomographyHead and Neck NeoplasmsNeoplasms, Unknown PrimaryNeoplasm MetastasisDiagnostic Imaging
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 8 , August 2013 , pp. 780 - 787
Copyright
Copyright © JLO (1984) Limited 2013 

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