FDG-PET/CT for oral focus assessment in head and neck cancer patients

The relationship between the uptake of alveolar bone inflammation and of cervical lymph nodes on fluoro-2-deoxy-D-glucose positron emission tomography

OBJECTIVES

To elucidate the relationships between the maximum standardized uptake value (SUVmax) of alveolar bone and those of lymph nodes (LNs) around the neck on 18F-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET).

METHODS

The SUVmax values of alveolar bone and of level IA, level IB, and level IIA LNs of 174 patients, including those with and without active odontogenic inflammation, on PET/CT performed for a health check were retrospectively evaluated. The upper and lower jaws were divided into four blocks (right maxilla, left maxilla, right mandible, and left mandible). The SUVmax values of each block and of the LNs were calculated. The differences in the SUVmax of each LN level between patients with and without odontogenic inflammation, and the relationship between the SUVmax values of alveolar bone and of the LNs were analysed statistically.

RESULTS

Significant differences in SUVmax values of bilateral level IB and IIA LNs were found between patients with and without odontogenic inflammation (Mann-Whitney U test: right level IB, P = .008; left level IB, P = .006; right level IIA, P < .001; left level IIA, P = .002), but not in bilateral level IA LNs (Mann-Whitney U test: right level IA, P = .432; left level IA, P = .549). The inflammatory site with the highest SUVmax in level IB LNs was the ipsilateral mandible (multivariate analysis: right, beta = 0.398, P < .001; left, beta = 0.472, P < .001), and the highest SUVmax in level IIA LNs was the ipsilateral maxilla (multivariate analysis: right, beta = 0.223, P = .002; left, beta = 0.391, P < .001).

CONCLUSIONS

The SUVmax values of level IB and IIA LNs were associated with a tendency towards a higher SUVmax value of alveolar bone on 18F-FDG-PET.