Can 3′-Deoxy-3′-(18F) Fluorothymidine Out Perform 2-Deoxy-2-(18F) Fluoro-d-Glucose Positron Emission Tomography/Computed Tomography in the Diagnosis of Cervical Lymphadenopathy in Patients With Oral/Head and Neck Cancer?

Joshua D. Schaefferkoetter, Eric Carlson, Robert Heidel

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose The present study investigated the performance of cellular metabolism imaging with 2-deoxy-2-(18F) fluoro-d-glucose (FDG) versus cellular proliferation imaging with 3′-deoxy-3′-(18F) fluorothymidine (FLT) in the detection of cervical lymph node metastases in oral/head and neck cancer. Materials and Methods We conducted a prospective cohort study to assess a head-to-head performance of FLT imaging and clinical FDG imaging for characterizing cervical lymph node metastases in patients with squamous cell carcinoma (SCC) of the oral/head and neck region. The primary predictor variable of the study was the presence of FDG or FLT avidity within the cervical lymph nodes. The primary outcome variable was the histologic presence of metastatic SCC in the cervical lymph nodes. The performance was reported in terms of the sensitivity, specificity, accuracy, and positive and negative predictive values. The overall accuracy for discriminating positive from negative lymph nodes was evaluated as a function of the positron emission tomography (PET) standardized uptake value (SUV). Receiver operating characteristic (ROC) analyses were performed for both tracers. Results Eleven patients undergoing surgical resection of SCC of the oral/head and neck region underwent preoperative FDG and FLT PET-computed tomography (CT) scans on separate days. The interpretation of the FDG PET-CT imaging resulted in sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 43.2, 99.5, 94.4, 88.9, and 94.7%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for FLT PET-CT imaging was 75.7, 99.2, 97.1, 90.3, and 97.7%, respectively. The areas under the curve for the ROC curves were 0.9 and 0.84 for FDG and FLT, respectively. Poor correlation was observed between the SUV for FDG and FLT within the lymph nodes and tumors. Conclusion FLT showed better overall performance for detecting lymphadenopathy on qualitative assessment within the total nodal population. This notwithstanding, FDG SUV performed better for pathologic discrimination within the visible lymph nodes.

Original languageEnglish (US)
Article number56619
Pages (from-to)1420-1428
Number of pages9
JournalJournal of Oral and Maxillofacial Surgery
Volume73
Issue number7
DOIs
StatePublished - Jan 1 2015

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Mouth Neoplasms
Head and Neck Neoplasms
Lymph Nodes
Glucose
Sensitivity and Specificity
ROC Curve
Neoplasm Metastasis
alovudine
Lymphadenopathy
Positron Emission Tomography Computed Tomography
Positron-Emission Tomography
Area Under Curve
Squamous Cell Carcinoma
Cohort Studies
Cell Proliferation
Prospective Studies
Population

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

Cite this

@article{d8402550c7b542c886bae7fa45a63b0a,
title = "Can 3′-Deoxy-3′-(18F) Fluorothymidine Out Perform 2-Deoxy-2-(18F) Fluoro-d-Glucose Positron Emission Tomography/Computed Tomography in the Diagnosis of Cervical Lymphadenopathy in Patients With Oral/Head and Neck Cancer?",
abstract = "Purpose The present study investigated the performance of cellular metabolism imaging with 2-deoxy-2-(18F) fluoro-d-glucose (FDG) versus cellular proliferation imaging with 3′-deoxy-3′-(18F) fluorothymidine (FLT) in the detection of cervical lymph node metastases in oral/head and neck cancer. Materials and Methods We conducted a prospective cohort study to assess a head-to-head performance of FLT imaging and clinical FDG imaging for characterizing cervical lymph node metastases in patients with squamous cell carcinoma (SCC) of the oral/head and neck region. The primary predictor variable of the study was the presence of FDG or FLT avidity within the cervical lymph nodes. The primary outcome variable was the histologic presence of metastatic SCC in the cervical lymph nodes. The performance was reported in terms of the sensitivity, specificity, accuracy, and positive and negative predictive values. The overall accuracy for discriminating positive from negative lymph nodes was evaluated as a function of the positron emission tomography (PET) standardized uptake value (SUV). Receiver operating characteristic (ROC) analyses were performed for both tracers. Results Eleven patients undergoing surgical resection of SCC of the oral/head and neck region underwent preoperative FDG and FLT PET-computed tomography (CT) scans on separate days. The interpretation of the FDG PET-CT imaging resulted in sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 43.2, 99.5, 94.4, 88.9, and 94.7{\%}, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for FLT PET-CT imaging was 75.7, 99.2, 97.1, 90.3, and 97.7{\%}, respectively. The areas under the curve for the ROC curves were 0.9 and 0.84 for FDG and FLT, respectively. Poor correlation was observed between the SUV for FDG and FLT within the lymph nodes and tumors. Conclusion FLT showed better overall performance for detecting lymphadenopathy on qualitative assessment within the total nodal population. This notwithstanding, FDG SUV performed better for pathologic discrimination within the visible lymph nodes.",
author = "Schaefferkoetter, {Joshua D.} and Eric Carlson and Robert Heidel",
year = "2015",
month = "1",
day = "1",
doi = "10.1016/j.joms.2015.01.002",
language = "English (US)",
volume = "73",
pages = "1420--1428",
journal = "Journal of Oral and Maxillofacial Surgery",
issn = "0278-2391",
publisher = "W.B. Saunders Ltd",
number = "7",

}

TY - JOUR

T1 - Can 3′-Deoxy-3′-(18F) Fluorothymidine Out Perform 2-Deoxy-2-(18F) Fluoro-d-Glucose Positron Emission Tomography/Computed Tomography in the Diagnosis of Cervical Lymphadenopathy in Patients With Oral/Head and Neck Cancer?

AU - Schaefferkoetter, Joshua D.

AU - Carlson, Eric

AU - Heidel, Robert

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Purpose The present study investigated the performance of cellular metabolism imaging with 2-deoxy-2-(18F) fluoro-d-glucose (FDG) versus cellular proliferation imaging with 3′-deoxy-3′-(18F) fluorothymidine (FLT) in the detection of cervical lymph node metastases in oral/head and neck cancer. Materials and Methods We conducted a prospective cohort study to assess a head-to-head performance of FLT imaging and clinical FDG imaging for characterizing cervical lymph node metastases in patients with squamous cell carcinoma (SCC) of the oral/head and neck region. The primary predictor variable of the study was the presence of FDG or FLT avidity within the cervical lymph nodes. The primary outcome variable was the histologic presence of metastatic SCC in the cervical lymph nodes. The performance was reported in terms of the sensitivity, specificity, accuracy, and positive and negative predictive values. The overall accuracy for discriminating positive from negative lymph nodes was evaluated as a function of the positron emission tomography (PET) standardized uptake value (SUV). Receiver operating characteristic (ROC) analyses were performed for both tracers. Results Eleven patients undergoing surgical resection of SCC of the oral/head and neck region underwent preoperative FDG and FLT PET-computed tomography (CT) scans on separate days. The interpretation of the FDG PET-CT imaging resulted in sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 43.2, 99.5, 94.4, 88.9, and 94.7%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for FLT PET-CT imaging was 75.7, 99.2, 97.1, 90.3, and 97.7%, respectively. The areas under the curve for the ROC curves were 0.9 and 0.84 for FDG and FLT, respectively. Poor correlation was observed between the SUV for FDG and FLT within the lymph nodes and tumors. Conclusion FLT showed better overall performance for detecting lymphadenopathy on qualitative assessment within the total nodal population. This notwithstanding, FDG SUV performed better for pathologic discrimination within the visible lymph nodes.

AB - Purpose The present study investigated the performance of cellular metabolism imaging with 2-deoxy-2-(18F) fluoro-d-glucose (FDG) versus cellular proliferation imaging with 3′-deoxy-3′-(18F) fluorothymidine (FLT) in the detection of cervical lymph node metastases in oral/head and neck cancer. Materials and Methods We conducted a prospective cohort study to assess a head-to-head performance of FLT imaging and clinical FDG imaging for characterizing cervical lymph node metastases in patients with squamous cell carcinoma (SCC) of the oral/head and neck region. The primary predictor variable of the study was the presence of FDG or FLT avidity within the cervical lymph nodes. The primary outcome variable was the histologic presence of metastatic SCC in the cervical lymph nodes. The performance was reported in terms of the sensitivity, specificity, accuracy, and positive and negative predictive values. The overall accuracy for discriminating positive from negative lymph nodes was evaluated as a function of the positron emission tomography (PET) standardized uptake value (SUV). Receiver operating characteristic (ROC) analyses were performed for both tracers. Results Eleven patients undergoing surgical resection of SCC of the oral/head and neck region underwent preoperative FDG and FLT PET-computed tomography (CT) scans on separate days. The interpretation of the FDG PET-CT imaging resulted in sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 43.2, 99.5, 94.4, 88.9, and 94.7%, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for FLT PET-CT imaging was 75.7, 99.2, 97.1, 90.3, and 97.7%, respectively. The areas under the curve for the ROC curves were 0.9 and 0.84 for FDG and FLT, respectively. Poor correlation was observed between the SUV for FDG and FLT within the lymph nodes and tumors. Conclusion FLT showed better overall performance for detecting lymphadenopathy on qualitative assessment within the total nodal population. This notwithstanding, FDG SUV performed better for pathologic discrimination within the visible lymph nodes.

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U2 - 10.1016/j.joms.2015.01.002

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