Evaluation of T2 value for detection of metastatic cervical lymph node in head and neck squamous cell carcinoma compared with 18F-FDG PET/CT

Authors

  • Netsiri Dumrongpisutikul Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • Vorada Sonthithavorn Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand and King Chulalongkorn Memorial Hospital, Bangkok, Thailand

Keywords:

Cervical lymph node, head and neck cancers, PET/CT, squamous cell carcinoma, T2 signal value

Abstract

Background: Difference in the staging of head and neck cancer leads to different treatments and managements of the patients to minimize mortality and improve long-term health and social consequences.

Objective: This study aimed to utilize the T2 signal value on T2WI for early detection of metastatic lymph nodes.

Methods: We retrospectively reviewed 18-fluoro-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and magnetic resonance imaging (MRI) results of patients with head and neck squamous cell carcinomas, from January 2012 to February 2018. The ratio between the T2 signal values of the lymph nodes and sternocleidomastoid muscles were calculated for each lymph node. Analytical comparisons between T2 signal value ratios of the lymph nodes with and without 18F-FDG PET uptake were performed. The differences of T2 signal value ratios in pre-treatment and post-radiation lymph nodes were analyzed.

Results: Twenty-six patients were recruited, with 54 lymph nodes in the suspected malignant group and 50 lymph nodes from the suspected benign group. There was no significant T2 signal value ratios in the suspected metastatic as compared with benign nodes. However, the minimum T2 signal value ratio of the suspected benign group was not lower than 1.5. The receiver operating characteristic (ROC) analysis of the mean T2 signal value ratio at cut-off value of 1.33 showed an area under the curve (AUC) of 0.55, a sensitivity of 57.14% and a specificity of 56.25%. History of previous radiation on the neck region showed significantly decreased T2 signal value ratios when both groups of lymph nodes were combined and in the suspected benign group. Inter-observer reliability was excellent (ICC 0.870).

Conclusions: No cut-off T2 signal value ratio exhibits high sensitivity or specificity for detection of metastatic lymph nodes.

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References

Gupta B, Newell J, Narinder K. Global epidemiology of head and neck cancers: a continuing challenge. Oncology 2016;91:13-23. https://doi.org/10.1159/000446117

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Head and neck cancers version 1 [Internet]. 2018 [cited 2018 Feb 15]. Available from: https://www.nccn.org.

Cavazuti B, Hudgins P, Rath T, Branstetter C, Baugnon K, Corey A, et al. Neck imaging reporting and data system: an atlas of NI-RADS categories for head and neck cancer [Internet]. 2018 [cited 2018 Feb 15]. Available from: https://www.acr.org/-/media/ACR/Files/RADS/NI-RADS/NIRADS-Atlas.pdf.

Beggs AD, Hain SF, Curran KM, O'Doherty MJ. FDG-PET as a "metabolic biopsy" tool in non-lung lesions with indeterminate biopsy. Eur J Nucl Med Mol Imaging 2002;29:542-6.

https://doi.org/10.1007/s00259-001-0736-7

Workman R, Coleman R. PET/CT essentials for clinical practice. Palo Alto, CA: Ebrary; 2007.

https://doi.org/10.1007/978-0-387-38335-4

Li C, Meng S, Yang X, Wang J, Hu J. The value of T2* in differentiating metastatic from benign axillary lymph nodes in patients with breast cancer-a preliminary in vivo study. PLoS One 2014;9:e84038.

https://doi.org/10.1371/journal.pone.0084038

Choi YJ, Lee JH, Kim HO, Kim DY, Yoon RG, Cho SH, et al. Histogram analysis of apparent diffusion coefficients for occult tonsil cancer in patients with cervical nodal metastasis from an unknown primary site at presentation. Radiology 2016;278:146-55. https://doi.org/10.1148/radiol.2015141727

Zhong J, Lu Z, Xu L, Dong L, Qiao H, Hua R, et al. The diagnostic value of cervical lymph node metastasis in head and neck squamous carcinoma by using diffusion-weighted magnetic resonance imaging and computed tomography perfusion. Biomed Res Int 2014;2014:260859.

https://doi.org/10.1155/2014/260859

Jin GQ, Yang J, Liu LD, Su DK, Wang DP, Zhao SF, et al. The diagnostic value of 1.5-T diffusion-weighted MR imaging in detecting 5 to 10 mm metastatic cervical lymph nodes of nasopharyngeal carcinoma. Medicine (Baltimore) 2016;95:e4286. https://doi.org/10.1097/MD.0000000000004286

Acampora A, Manzo G, Fenza G, Busto G, Serino A, Manto A. High b-value diffusion MRI to differentiate recurrent tumors from post treatment changes in head and neck squamous cell carcinoma: a single center prospective study. Biomed Res Int 2016;2016:2865169.

https://doi.org/10.1155/2016/2865169

Lell M, Baum U, Greess H, Nomayr A, Nkenke E, Koester M, et al. Head and neck tumors: imaging recurrent tumor and post-therapeutic changes with CT and MRI. Eur J Radiol 2000;33:239-47.

https://doi.org/10.1016/S0720-048X(99)00120-5

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Published

2023-10-27

How to Cite

1.
Dumrongpisutikul N, Sonthithavorn V. Evaluation of T2 value for detection of metastatic cervical lymph node in head and neck squamous cell carcinoma compared with 18F-FDG PET/CT. Chula Med J [Internet]. 2023 Oct. 27 [cited 2024 Oct. 12];63(4). Available from: https://he05.tci-thaijo.org/index.php/CMJ/article/view/1127