Objective: The purpose of this study was to evaluate whether dual-time-point fluorodeoxyglucose positron emission tomography/computed tomography image can improve nodal diagnosis in patients with head and neck squamous cell carcinoma (HNSCC).
Methods: One hundred six HNSCC patients were enrolled. Positron emission tomography/computed tomography images were obtained twice: 1 and 2 hours after fluorodeoxyglucose injection. Maximum standardized uptake value (SUVmax) and SUVmax increasing rate (SUV-IR) were compared with the histopathologic findings to determine the optimal cutoff for nodal diagnosis.
Results: Using early-phase image, SUVmax ≧ 2.75 was considered as optimal criterion. When using delayed-phase, SUVmax ≧ 3.5 was optimal. There was no significant difference between these criteria. Maximum standardized uptake value IR ≧ 8.0 (10/s) was considered as optimal, although it provided relatively low sensitivity (66%) and specificity (82%). However, combined criterion of SUVmax ≧ 3.5 in delayed-phase or SUV-IR ≧ 8.0 (10/s) significantly improved the specificity (90%) and accuracy (89%) without decreasing the sensitivity (84%).
Conclusions: Using delayed-phase image combined with SUV-IR can improve the nodal diagnosis in HNSCC patients.
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