FDG-PET in the clinically negative neck in oral squamous cell carcinoma.

Abstract

OBJECTIVE: With improved diagnostic imaging techniques, it remains difficult to reduce occult metastatic disease in oral squamous cell carcinoma (SCC) to less than 20%. Therefore, supraomohyoid neck dissection (SOHND) still is a valuable staging procedure in these patients. METHODS: Patients with clinically and ultrasonographically staged cN0 SCC of the oral cavity underwent FDG-PET before SOHND. Histologic examination of neck dissection specimens was used as a "gold standard." RESULTS: Twenty-eight consecutive patients were included, representing 30 necks. Occult metastatic disease was found in 30% of SOHND specimens. Average diameter of metastatic deposits was 4.3 mm. Sensitivity, specificity, and accuracy of FDG-PET was 33%, 76%, and 63%, respectively. CONCLUSIONS: In patients with cN0 SCC of the oral cavity, FDG-PET does not contribute to the preoperative workup. FDG-PET does not replace SOHND as a staging procedure.