Ahmet URAL, Amir MİNOVİ, Andreas HERTEL, Erich HORFMANN, Wolfgang DRAF, Ulrike BOCKMUEHL

Baş-boyun bölgesi yassı hücreli karsinomlarm tedavi öncesi değerlendirilmesinde PET MRG'den üstün müdür?

Amaç: Bu çalışmada, yassı hücreli baş-boyun karsinomlarının tedavi öncesi değerlendirilmesinde pozitron emisyon tomografisi PET ve manyetik rezonans görüntülemenin MRG etkinliğinin karşılaştırılması amaçlandı.Hastalar ve Yöntemler: Çalışmaya baş-boyun bölgesi yassı hücreli karsinomu olan 34 ardışık hasta alındı. Tüm hastalar tedavi öncesinde tüm vücut [18F]florodeoksiglukoz FDG -PET ve MRG görüntülemesi ile değerlendirildi. Tüm hastaların tanıları endoskopik biyopsi örneklerinin histopatolojik değerlendirilmesi ile doğrulandı.Bulgular: Primer tümörlerin yerleşimleri şöyleydi: orofarenks n=15, %44 , larenks n=10, %29 , hipofarenks n=8, %24 , nazofarenks n=1, %3 . Yirmi hastada %59 cerrahi tedavi uygulandı; bu hastalara 23 boyun diseksiyonu yapıldı. On dört hastada %41 radyoterapi uygulandı. Her iki görüntüleme yöntemi de 33 hastada %97 primer tümörü doğru olarak saptayabildi. Ayrıca, PET yardımıyla iki hastada %6 akciğer ve iliyak kemikte uzak metastazlar saptandı; bunların hepsi biyopsi sonuçlarıyla doğrulandı. Boyun diseksiyonlarının yedisinde %30 lenf nodu metastazı vardı. Lenf nodu tutulumunun gösterilmesinde duyarlılık ve özgüllük oranları PET için sırasıyla %100 ve %87.5, MRG için %85.7 ve %87.5 bulundu.Sonuç: Nodal hastalığın ve uzak metastazların saptanmasında PET MRGʼden daha üstün görünmesine rağmen, bu yöntemi baş-boyun kanserlerinin tedavi öncesi değerlendirilmesinde esas araç olarak önermek sınırlı kullanımı ve yüksek maliyeti nedeniyle erkendir

Anahtar Kelimeler:

Yası hücreli karsinom/radyonüklid görüntüleme, baş-boyun tümörleri, manyetik rezonans görüntüleme, tümör evrelemesi, pozitron emisyon tomografisi

Is PET superior to MRI in the pretherapeutic evaluation of head and neck squamous celi carcinoma?

Objectives: This study was designed to compare the effectiveness of positron emission tomography PET and magnetic resonance imaging MRI in the prethera peutic staging of squamous celi carcinoma SCC of the head and neck.Patients and Methods: The study included 34 consecu- tive patients 27 males, 7 females; mean age 61 years; range 42 to 82 years with SCC of the head and neck. Ali thepatientsunderwentwholebody[18Flfluorodeoxyglucose FDG -PET and MRI seans for pretherapeutic evaluation.Diagnoses were confirmed by histopathologic examina- tion of endoscopic biopsy specimens.Results: The sites of the primary tumors were the oro- pharynx n=15, 44% , larynx n=10, 29% , hypopharynx n=8, 24% , and nasopharynx n=1, 3% . Surgery was the treatment of choice in 20 patients 59% , ineluding 23 neck disseetions. Fourteen patients 41% were treated with radiochemotherapy. Both PET and MRI were able to detect the primary tumor in 33 cases 97% . İn two patients 6% , PET was able to detect distant metastases in the lung and iliac bone, ali of which were confirmed by biop- sies. Seven neck specimens 30% showed lymph node metastasis. Sensitivity and specificity rates for deteetion of lymph node metastasis were 100% and 87.5% for PET, and 85.7% and 87.5% for MRI, respeetively.Conclusion: Although PET seems to be superior to MRI in deteeting nodal disease and distant metastases, it is stili early to recommend it as a primary tool for pre therapeutic evaluation of head and neck cancers due to its limited availability and higher cost.

Keywords:

Carcinoma squamous cell/radionuclide imaging, head and neck neoplasms, magnetic resonance imaging, neoplasm staging, positron-emission tomography,

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