Diagnostic sensitivity of 18fluorodeoxyglucose positron emission tomography for detecting synchronous multiple primary cancers in head and neck cancer patients

Department of Biology and Function in the Head and Neck, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
Archives of Oto-Rhino-Laryngology (Impact Factor: 1.55). 10/2011; 269(5):1503-7. DOI: 10.1007/s00405-011-1784-7
Source: PubMed


We assessed the sensitivity of positron emission tomography (PET) for detecting synchronous multiple primary cancers, particularly synchronous esophageal cancers in head and neck cancer patients. We retrospectively reviewed 230 head and neck cancer patients. All the patients routinely underwent the following examinations: urinalysis, occult blood, tumor marker detection [squamous cell carcinoma (SCC), cytokeratin fragment (CYFRA), and carcinoembryonic antigen (CEA)], esophagogastroduodenoscopy, colonoscopy (when CEA was high or occult blood was positive), abdominal ultrasonography, plain chest computed tomography (CT), and PET. Bronchoscopy was performed when CT revealed lung shadow of central region. Synchronous multiple primary cancers were detected in 42 (18.2%) patients. The diagnostic sensitivity of PET for synchronous primary cancers was as follows: esophagus, 7.6% (1/13); stomach, 25.0% (2/8); lung, 66.7% (4/6); head and neck, 75.0% (3/4); colon, 0% (0/1); kidney, 0% (0/1); and subcutaneous, 100% (1/1). The sensitivity of PET for detecting synchronous esophageal cancers is low because these are early-stage cancers (almost stage 0-I). Therefore, it is necessary to perform esophagogastroduodenoscopy for detecting synchronous esophageal cancers. PET is an important additional tool for detecting synchronous multiple primary cancers because the diagnostic sensitivity of PET in synchronous head and neck cancer and lung cancer is high. But PET has the limitation of sensitivity for synchronous multiple primary cancers because the diagnostic sensitivity of PET in synchronous esophageal cancer is very low.

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    • "PET can characterize benign or malign character of tumor correctly and diagnose metastases early (Kumar et al. 2003). 18 F-FDG can be used in the diagnosis and evaluation of outcome prediction and disease extension in several tumors such as small cell lung cancer (Arslan et al. 2011), head and neck canncers (Kondo et al. 2011), extranodal lymphoma (Ilica et al. 2011), cervical carcinoma (Cetina et al. 2011), colorectal tumors (Peng et al. 2011) and so on. Therefore, depening on its sensitivity the physician can decide therapy plan such as applying chemotherapy or surgery. "
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