High diagnostic accuracy for lymph node metastasis of oral squamous cell carcinoma using PET/CT with a silicon photomultiplier

Ikuho Kojima; Kentaro Takanami; Takenori Ogawa; Kenichiro Ishikawa; Yohei Morishita; Ryo Ishii; Akira Ohkoshi; Ayako Nakanome; Hayato Odagiri; Masahiro Iikubo

doi:10.1007/s11282-022-00588-0

High diagnostic accuracy for lymph node metastasis of oral squamous cell carcinoma using PET/CT with a silicon photomultiplier

Oral Radiol. 2022 Oct;38(4):540-549. doi: 10.1007/s11282-022-00588-0. Epub 2022 Jan 21.

Authors

Ikuho Kojima^{1

2}, Kentaro Takanami³, Takenori Ogawa^{4

5

6}, Kenichiro Ishikawa^{4

5}, Yohei Morishita^{4

3}, Ryo Ishii^{4

5}, Akira Ohkoshi^{4

5}, Ayako Nakanome^{4

5}, Hayato Odagiri⁷, Masahiro Iikubo^{8

4}

Affiliations

¹ Department of Dental Informatics and Radiology, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. ikuhokojima@tohoku.ac.jp.
² Head and Neck Cancer Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan. ikuhokojima@tohoku.ac.jp.
³ Department of Diagnostic Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
⁴ Head and Neck Cancer Center, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
⁵ Department of Otolaryngology-Head and Neck Surgery, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
⁶ Department of Otolaryngology, Gifu University Hospital, 1-1 Yanagido, Gifu city, 501-1194, Japan.
⁷ Department of Radiology, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
⁸ Department of Dental Informatics and Radiology, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.

PMID: 35061164
DOI: 10.1007/s11282-022-00588-0

Abstract

Objective: The higher sensitivity of the new-generation positron emission tomography/computed tomography (PET/CT) with silicon photomultiplier (SiPM) may increase false-positive rates in detecting metastatic lymph nodes (LNs). This study aimed to clarify the usefulness of the SiPM PET scanner in diagnosing LN metastasis of oral squamous cell carcinoma (SCC).

Methods: We retrospectively reviewed consecutive F-18 fluorodeoxyglucose PET/CT images of 39 SCC patients using SiPM PET and 31 SCC patients using non-SiPM PET. We measured the maximum standardized uptake value (SUV_max) of the LNs on PET images and maximum short-axis diameter on transverse CT images.

Results: The sensitivity and specificity of SiPM PET were 86.2% and 95.6%, respectively (cut-off SUV_max, 4.6). The area under the curve (AUC) of SiPM PET (0.977; 95% confidence interval [CI], 0.958-0.995) was significantly higher than that of non-SiPM PET (0.825; 95% CI 0.717-0.934) (P < 0.01). In a size-limited analysis of diameter, the AUC of SiPM PET (≥ 0.96 for all diameters) was significantly higher than that of non-SiPM PET (tended to decrease as the LN diameter decreased) for the diagnosis of LN metastasis by SUV_max.

Conclusion: SiPM PET had higher diagnostic accuracy for LN metastasis of oral SCC than non-SiPM PET, even for small LN metastasis without increasing false-positives.

Keywords: Lymph node metastasis; Oral cancer; Positron emission tomography; Silicon photomultiplier; Squamous cell carcinoma.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Squamous Cell* / diagnostic imaging
Head and Neck Neoplasms*
Humans
Lymphatic Metastasis / diagnostic imaging
Mouth Neoplasms* / diagnostic imaging
Positron Emission Tomography Computed Tomography / methods
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck