Fulltext

FDG PET and PET/CT for the detection of the primary tumour in patients with cervical non-squamous cell carcinoma metastasis of an unknown primary

Paul, Stefan ; Stoeckli, Sandro ; von Schulthess, Gustav ; Goerres, Gerhard

In: European Archives of Oto-Rhino-Laryngology, 2007, vol. 264, no. 2, p. 189-195

Add to personal list
    Title
    • FDG PET and PET/CT for the detection of the primary tumour in patients with cervical non-squamous cell carcinoma metastasis of an unknown primary
    Author
    • Paul, Stefan. Interne Klinik Dr. Argirov, Kempfenhausen am Starnberger See, Muenchner Strasse 23-29, 82335, Berg, Germany
    • Stoeckli, Sandro. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
    • von Schulthess, Gustav. Nuclear Medicine, Department of Medical Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Goerres, Gerhard. Institute of Diagnostic Radiology, Department of Medical Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • European Archives of Oto-Rhino-Laryngology, 2007, vol. 264, no. 2, p. 189-195. Springer-Verlag
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:321777
    Summary
    In patients with a neck metastasis from an unknown primary with non-squamous cell cancer (non-SCC) histology, the primary is often located outside the head and neck area. We retrospectively evaluated 326 patient records and found 14 patients with non-SCC neck lymph node metastasis from an unknown primary undergoing whole body F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) with or without coregistered computed tomography (PET/CT). The PET or PET/CT findings were verified by pathological work-up, additional imaging tests, and clinical follow-up. PET detected pathological FDG uptake suspicious for the primary in eight patients. PET or PET/CT findings were true positive in seven patients, true negative in 4, false positive in 1, and false negative in two patients. In one patient PET/CT revealed a synchronous ovarian carcinoma. The results suggest that whole body imaging with FDG PET and PET/CT can be useful to identify unknown primaries of non-SCC origin. However, the work-up of patients undergoing PET or PET/CT in our study was very heterogeneous and the primary was more likely found in patients without extensive imaging before PET scanning. Further studies should evaluate if the histology of a neck nodal metastasis should influence the choice of the imaging method and the role of PET and PET/CT imaging for the work up of patients with a non-SCC neck lymph node metastasis of an unknown primary