@misc{oai:repo.qst.go.jp:00070284,
 author = {Ohashi, Seiya and Yoshikawa, Kyosan and Toubaru, Sachiko and Hasebe, Mitsuhiko and Ishikawa, Hiroyuki and Sagou, Kenji and Tamura, Katsumi and Tanimoto, Katsuyuki and Kandatsu, Susumu and Mizoe, Junetsu and Fukumura, Toshimitsu and Saga, Tsuneo and Kawaguchi, Koji and Kamada, Tadashi and 大橋 靖也 and 吉川 京燦 and 桃原 幸子 and 長谷部 充彦 and 石川 博之 and 田村 克巳 and 谷本 克之 and 神立 進 and 溝江 純悦 and 福村 利光 and 佐賀 恒夫 and 鎌田 正},
 month = {Oct},
 note = {PURPOSE Wesometimes encounter nodular activities in neck area of patients with cancer onwhole body PET/CT using C-11 methionine (MET). However, these nodularactivities are not necessarily the case that they are true metastasis. There isa possibility that the nodular activities may be physiological or inflammatoryaccumulation or depiction of intravascular radioisotope. We evaluateddetectability of MET-PET/CT for neck lymphnode metastasis from primary head andneck cancer, and we compared the difference of diagnostic accuracy amonghistopathological classifications of primary lesions. METHODS AND MATERIALS Wereviewed MET-PET/CT images of 351 studies of head and neck cancer patients,from June 2006 to December 2008, searching for any nodular accumulation in neckarea. We picked 49 patients up with any nodular accumulation in neck area assuspicious candidates for lymphnode metastasis. There were 68 lesions in total.Pathology of primary tumor were squamous cell carcinoma (SCC) in 19 nodules,malignant melanoma (MM) in 18 nodules, adenoid cystic carcinoma (ACC) in 12nodules, and others in 19 nodules. All sites of nodular accumulation wereconfirmed by pathology or by clinical follow-up. We evaluated diagnosticindexes (Sensitivity, Specificity, Accuracy etc.) for all nodules together andfor each histology, and we compared the difference of indexes amonghistopathologies of primary lesions. We use TNR, tumor to normal tissue ratio,to estimate MET accumulation. RESULTS Twenty-seven nodules in 18 patients foundout as metastasis. Fourteen positive nodules were from SCC, four were from MM,one was from ACC, and eight were from other pathological tumors. Each positiveratio was 39.7%, 73.7%, 77.8% and 8.3%, respectively. When we use a cutoff TNRvalue, 2.70 derived from all 68 nodules, to diagnose metastasis, sensitivity,specificity and accuracy for total nodules were 58.6%, 74.4% and 67.7%,respectively. And the three diagnostic indexes using the same cutoff value(2.70 TNR) for SCC, MM and ACC were 64.3%, 100.0%, 73.7%, and 75.0%, 50.0%,55.6%, and 100.0%, 81.8%, 83.3%, respectively. But if we determined cutoffvalues independently for SCC, MM, and ACC, the accuracy were improved to 89.5%,88.9% and 91.7%, respectively. CONCLUSION MET-PET/CT was useful for diagnosisof neck lymphnode metastasis from head and neck cancer, but the cutoff valuefor distinction of metastasis was very important. The cutoff values determinedindependently for histopathological classifications of primary lesions mightimprove the diagnostic accuracy., The 2010 EANM Congress},
 title = {Diagnostic accuracy of C-11 methionine PET/CT for cervical lymph node metastasis from head and neck cancer: a comparison of histopathological classifications of primary lesions},
 year = {2010}
}