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Clinical value of 18F-FDG-PET/CT in staging cutaneous squamous cell carcinoma.
Nucl Med Commun 2019; 40(7):744-751NM

Abstract

BACKGROUND

Cutaneous squamous cell carcinoma (cSCC) is the second most common skin malignancy. Computed tomography (CT) and/or MRI are commonly used for staging, however, the role of fluorine-18-fluorodeoxyglucose (F-FDG)-PET is not clearly established. In this study, we evaluated F-FDG-PET/CT imaging for initial staging of cSCC.

PATIENTS AND METHODS

F-FDG-PET/CT scans performed in patients with newly diagnosed cSCC were reviewed retrospectively. Images were visually assessed for lesions and F-FDG uptake [standardized uptake value (SUV)] in primary and secondary sites was measured. Suspected lesions on F-FDG-PET/CT were correlated with histopathology when available, follow-up imaging or clinical data in others.

RESULTS

Twenty-three cSCC patients who underwent F-FDG-PET/CT at diagnosis were evaluated. Primary sites were in head/neck (n=21), chest (n=1), and foot (n=1). All patients had F-FDG-positive scans with a total of 51 F-FDG-positive lesions. All primary lesions (n=24) were F-FDG-positive (SUV: 2.3-22.8; mean 10.2), and additional 27 F-FDG-positive lesions, including 21 nodes, four cutaneous, one osseous and one lung lesion, were noted in 13 patients. Mean size of F-FDG-positive nodes was 0.9 cm (range: 0.4-2.5 cm), predominantly clinically impalpable. Pathology was available for 40/51 lesions; 31 sites positive for malignancy. SUV (mean±SD) was 9.2±6.2 for malignant and 2.7±1.2 for benign lesions. Sensitivity, positive predictive value, and accuracy of F-FDG-PET/CT scan were 100, 77.5, and 77.5%, respectively. F-FDG detected seven additional lesions in three patients, compared to CT/MRI. Overall, staging F-FDG-PET/CT detected nine prior unknown lesions in five patients that were proven metastatic disease by histopathology or follow-up; F-FDG-PET/CT modified management in 5/23 (21.7%) patients.

CONCLUSION

F-FDG-PET/CT has high sensitivity in the detection of cSCC lesions, including small cutaneous and nodal disease, and has a potential role in initial staging and management.

Authors+Show Affiliations

Departments of Radiology.Radiation Oncology.Surgery, Memorial Sloan Kettering Cancer Center.Departments of Radiology. Department of Radiology, Weill Cornell Medical College, New York, New York, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31095044

Citation

Mahajan, Sonia, et al. "Clinical Value of 18F-FDG-PET/CT in Staging Cutaneous Squamous Cell Carcinoma." Nuclear Medicine Communications, vol. 40, no. 7, 2019, pp. 744-751.
Mahajan S, Barker CA, Singh B, et al. Clinical value of 18F-FDG-PET/CT in staging cutaneous squamous cell carcinoma. Nucl Med Commun. 2019;40(7):744-751.
Mahajan, S., Barker, C. A., Singh, B., & Pandit-Taskar, N. (2019). Clinical value of 18F-FDG-PET/CT in staging cutaneous squamous cell carcinoma. Nuclear Medicine Communications, 40(7), pp. 744-751. doi:10.1097/MNM.0000000000001029.
Mahajan S, et al. Clinical Value of 18F-FDG-PET/CT in Staging Cutaneous Squamous Cell Carcinoma. Nucl Med Commun. 2019;40(7):744-751. PubMed PMID: 31095044.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical value of 18F-FDG-PET/CT in staging cutaneous squamous cell carcinoma. AU - Mahajan,Sonia, AU - Barker,Christopher A, AU - Singh,Bhuvanesh, AU - Pandit-Taskar,Neeta, PY - 2019/5/17/pubmed PY - 2019/5/17/medline PY - 2019/5/17/entrez SP - 744 EP - 751 JF - Nuclear medicine communications JO - Nucl Med Commun VL - 40 IS - 7 N2 - BACKGROUND: Cutaneous squamous cell carcinoma (cSCC) is the second most common skin malignancy. Computed tomography (CT) and/or MRI are commonly used for staging, however, the role of fluorine-18-fluorodeoxyglucose (F-FDG)-PET is not clearly established. In this study, we evaluated F-FDG-PET/CT imaging for initial staging of cSCC. PATIENTS AND METHODS: F-FDG-PET/CT scans performed in patients with newly diagnosed cSCC were reviewed retrospectively. Images were visually assessed for lesions and F-FDG uptake [standardized uptake value (SUV)] in primary and secondary sites was measured. Suspected lesions on F-FDG-PET/CT were correlated with histopathology when available, follow-up imaging or clinical data in others. RESULTS: Twenty-three cSCC patients who underwent F-FDG-PET/CT at diagnosis were evaluated. Primary sites were in head/neck (n=21), chest (n=1), and foot (n=1). All patients had F-FDG-positive scans with a total of 51 F-FDG-positive lesions. All primary lesions (n=24) were F-FDG-positive (SUV: 2.3-22.8; mean 10.2), and additional 27 F-FDG-positive lesions, including 21 nodes, four cutaneous, one osseous and one lung lesion, were noted in 13 patients. Mean size of F-FDG-positive nodes was 0.9 cm (range: 0.4-2.5 cm), predominantly clinically impalpable. Pathology was available for 40/51 lesions; 31 sites positive for malignancy. SUV (mean±SD) was 9.2±6.2 for malignant and 2.7±1.2 for benign lesions. Sensitivity, positive predictive value, and accuracy of F-FDG-PET/CT scan were 100, 77.5, and 77.5%, respectively. F-FDG detected seven additional lesions in three patients, compared to CT/MRI. Overall, staging F-FDG-PET/CT detected nine prior unknown lesions in five patients that were proven metastatic disease by histopathology or follow-up; F-FDG-PET/CT modified management in 5/23 (21.7%) patients. CONCLUSION: F-FDG-PET/CT has high sensitivity in the detection of cSCC lesions, including small cutaneous and nodal disease, and has a potential role in initial staging and management. SN - 1473-5628 UR - https://www.unboundmedicine.com/medline/citation/31095044/Clinical_value_of_18F-FDG-PET/CT_in_staging_cutaneous_squamous_cell_carcinoma L2 - http://Insights.ovid.com/pubmed?pmid=31095044 DB - PRIME DP - Unbound Medicine ER -