Use of F-18 FDG-PET/CT in Initial Staging of Cutaneous Squamous Cell Carcinoma
Posted: Monday, July 29, 2019
A new study suggests that fluorine-18 (F-18) fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) is a highly sensitive method of detecting cutaneous squamous cell carcinoma lesions. Sonia Mahajan, MD, of the Memorial Sloan Kettering Cancer Center in New York, and colleagues published their work in Nuclear Medicine Communications.
“F-18 FDG-PET/CT has high sensitivity in the detection of [cutaneous squamous cell carcinoma] lesions, including small cutaneous and nodal disease, and has a potential role in initial staging and management,” concluded the authors.
A total of 23 patients with newly diagnosed cutaneous squamous cell carcinoma lesions who underwent F-18 FDG-PET/CT scans were included in the study. The scans were assessed for lesions, and F-18 FDG uptake in both primary and secondary sites was measured. Primary cancer sites were in the head/neck (21 patients), chest (1), and foot (1), and all of these primary lesions were F-18 FDG–positive lesions. There were an additional 27 F-18-FDG–positive lesions, with 21 nodal, 4 cutaneous, 1 osseous, and 1 lung lesion present in 13 different patients. The average size of F-18 FDG–positive nodes was 0.9 cm, and most of them could not be palpated clinically.
Pathology reports were available for 40 of the 51 total lesions, and 31 were positive for malignancy. The F-18 FDG uptake (in standard uptake value) was 9.2 ± 6.2 for malignant lesions and 2.7 ± 1.2 for benign lesions. The sensitivity of the F-18 FDG-PET/CT scan was 100%, complemented by a positive predictive value of 77.5% and an accuracy of 77.5%. Of note, F-18 FDG detected seven more lesions in three patients compared with CT and magnetic resonance imaging and modified management in 21.7% of patients.
Disclosure: The study authors’ disclosure information can be found at journals.lww.com.