1st die positronen-emissions-tomographie (PET) zum nachweis tumorbefallener halslymphknoten bei plattenepithelkarzinomen des kopf- halsbereiches in der klinischen routine sinnvoll einsetzbar?

Objectives: Accurate determination of lymph node involvement is a prerequisite for individualized therapy in patients with squamous-cell carcinoma (SCC) of the head and neck region. In a previous study we have shown, that ¹⁸F-FDG-PET with and without attenuation correction is superior to MRI for this purpose in a scientific setting. In this study we evaluated the diagnostic accuracy of a shortened PET protocol (aquisition time 20 min) in a routine clinical setting. Design: Static, non-attenuation corrected PET in two bed positions starting 40 min after i.v. injection of 370 MBq ¹⁸F- FDG and morphologic procedures (CT and MRI) were compared prospectively in 70 patients for N-staging. Postoperative pathologic findings served as gold standard. Results: The diagnostic accuracy of PET for detecting 'neck sides' with malignant involvement was superior to morphologic procedures with a sensitivity and specificity of 87 and 94%, respectively, compared with CT values of 65 and 47% and MRI values of 88 and 41%, respectively. Conclusions: A short PET protocol which is suitable for routine clinical use, is superior to morphologic procedures (CT and MRI) in detection of lymph node involvement of head and neck squamous-cell carcinomas. Copyright (C) 2000 S. Karger AG, Basel.