Application Value Of PET And PET/CT In Cervical Lymph Node Metastasis Of Oral And Maxillofacial Malignancy

Section 1 Research on diagnostic value of PETand PET/CT in cervical lymph node metastasis of oralsquamous cell carcinomaObjective: To evaluate the clinical application value of positron emissiontomography (PET) and PET/CT in diagnosing cervical lymph node metastasis of oralsquamous cell carcinoma by comparison of CT , MRI examination and clinicalpalpation.Methods: 60 patients with oral squamous cell carcinoma who received PET orPET/CT, CT or MRI examination tow weeks before surgery between 1999 and 2009were analyzed retrospectively to obtainâ‘ PET or PET/CT images;â‘¡CT or MRIimages;â‘¢Lymph node status by clinical palpation. Pathological results wereadopted as gold standard to analyze the differences of sensitivity, specificity andaccuracy rate of above three methods in judging cervical lymph node metastasis.Results: The sensitivity of PET or PET/CT in judging lymph node metastasiswas 81.82%, The sensitivity of CT or MRI and clinical palpation in judging lymphnode metastasis was 77.27% and 68.18%, respectively; The specificity of PET orPET/CT in judging lymph node metastasis was 78.95%, The specificity of CT or MRIand clinical palpation was both 76.32%;The accuracy rate of PET or PET/CT, CT orMRI and clinical palpation was 80.00%, 76.67% and 73.33%, respectively. Conclusions: The sensitivity, specificity and accuracy rate of PET or PET/CT injudging cervical lymph node metastasis of oral squamous cell carcinoma was higherthan CT or MRI and clinical palpation. PET or PET/CT as a diagnosis method playedan important role in judging lymph node metastasis of oral squamous cell carcinoma.But the differences of accuracy rate(P=0.580),sensitivity(P=0.368) and specificity(P=0.936)did not show statistical significance.Section 2 The diagnostic value of PET/CT in lymph nodemetastasis of oral and maxillofacial cancerObjective: To evaluate the clinical application value of PET/CT in diagnosingcervical lymph node metastasis of oral and maxillofacial cancer by comparison ofPET/CT, MRI examination and clinical palpation.Methods:35 patients with oral and maxillofacial cancer who received PET/CT orMRI examination two weeks before surgery between 2008 and 2010 were analyzedprospectively to obtainâ‘ PET/CT images;â‘¡MRI images;â‘¢Lymph node status byclinical palpation. Pathological results were adopted as gold standard to analyze thedifferences of sensitivity, specificity and diagnostic accuracy of above three methodsin judging cervical lymph node metastasis.Results: The sensitivity of PET/CT in judging lymph node metastasis was 85%,The sensitivity of MRI and clinical palpation was 75% and 70%, respectively; Thespecificity of PET/CT in judging lymph node metastasis was 93.33%, The specificityof MRI and clinical palpation in judging lymph node metastasis was 80.00% and60.00%, respectively, PET/CT showed higher specificity than the others; Thediagnostic accuracy of PET/CT, MRI and clinical palpation was 88.57%, 77.14% and71.43%, respectively. Conclusions: PET/CT has significantly higher specificity in judging cervicallymph node metastasis of oral and maxillofacial cancer than MRI and clinicalpalpation, The specificity of PET/CT in judging lymph node metastasis was 13.33%and 33.33% higher than MRI and clinical palpation(P=0.006), respectively. PET/CTas a diagnosis method had important reference in judging lymph node metastasis oforal and maxillofacial cancer, But the differences of accuracy rate(P=0.103)andsensitivity(P=0.819)did not show statistical significance.