Hostname: page-component-8448b6f56d-wq2xx Total loading time: 0 Render date: 2024-04-16T20:00:52.369Z Has data issue: false hasContentIssue false
  • English
  • Français

Role of ultrasound-guided fine needle aspiration in assessing the impalpable cervical node with increased 18F-fluorodeoxyglucose uptake on positron emission tomography scanning: preliminary communication

Published online by Cambridge University Press:  13 June 2008

C-P Wang ,
C-Y Lee ,
P-J Lou ,
R-F Yen ,
J-K Hsiao  and
J-Y Ko
C-P Wang
Affiliation:
Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
C-Y Lee
Affiliation:
Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
P-J Lou
Affiliation:
Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
R-F Yen
Affiliation:
Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
J-K Hsiao
Affiliation:
Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
J-Y Ko*
Affiliation:
Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
*
Address for correspondence: Dr Jenq-Yuh Ko, Department of Otolaryngology, National Taiwan University Hospital, 7 Chung-Shan South Rd, Taipei, Taiwan. Fax: +886 2 23410905 E-mail: jyko@ntu.edu.tw
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

18F-Fluorodeoxyglucose positron emission tomography can detect cervical metastases before they are palpable. However, false positive results are not uncommon. This paper reports the use of ultrasound-guided fine needle aspiration to determine the nature of impalpable cervical nodes that are positive on positron emission tomography scanning.

Methods:

Ultrasound-guided fine needle aspiration was performed in 10 cancer patients with suspicious cervical nodes revealed by positron emission tomography scan. Clinical data were retrospectively reviewed.

Results:

The underlying cancers included lung cancer (three patients), nasopharyngeal carcinoma (two), oesophageal cancer (two), buccal cancer (one), bladder cancer (one) and Langerhan's histiocytosis (one). The lymph nodes were located in the supraclavicular region in four patients, the level II region in four, the level IV region in one and the accessory chain in one. Cytological examination was positive for malignant cells in eight patients, all of whom received salvage treatment. Two of these patients died of distant metastases. Cytological examination revealed a benign or reactive lesion in two patients, who at the time of writing were alive and well, 19 and 36 months after examination.

Conclusions:

Ultrasound-guided fine needle aspiration is a minimally invasive procedure which enables cytological examination of suspicious cervical lymph nodes detected by positron emission tomography scanning, allowing further treatment to be planned.

Keywords

Positron Emission TomographyHead and Neck NeoplasmsNeoplasm MetastasisUltrasoundNeedle Biopsy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 12 , December 2008 , pp. 1349 - 1353
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Johnson, JT. A surgeon looks at cervical lymph nodes. Radiology 1990;175:607–10CrossRefGoogle ScholarPubMed
2Tran, BN, Grigsby, PW, Dehdashti, F, Herzog, TJ, Siegel, BA. Occult supraclavicular lymph node metastasis identified by FDG-PET in patients with carcinoma of the uterine cervix. Gynecol Oncol 2003;90:572–6CrossRefGoogle ScholarPubMed
3Di Paolo, M, Tulusan, AH, Breuel, C, Wilczek-Engelmann, T, Adam, R, Reitzenstein, M. Value of scalene lymph node biopsy in the treatment plan of advanced cervix cancer [in German]. Geburtshilfe Frauenheilkd 1990;50:310–13CrossRefGoogle ScholarPubMed
4Ng, SH, Ko, SF, Toh, CH, Chen, YL. Imaging of neck metastases. Chang Gung Med J 2006;29:119–29Google ScholarPubMed
5Wahl, RL. Targeting glucose transporters for tumor imaging: “sweet” idea, “sour” result. J Nucl Med 1996;37:1038–41Google ScholarPubMed
6Chang, JT, Chan, SC, Yen, TC, Liao, CT, Lin, CY, Lin, KJ et al. Nasopharyngeal carcinoma staging by (18)F-fluorodeoxyglucose positron emission tomography. Int J Radiat Oncol Biol Phys 2005;62:501–7CrossRefGoogle ScholarPubMed
7Ng, SH, Yen, TC, Chang, JT, Chan, SC, Ko, SF, Wang, HM et al. Prospective study of [18F]fluorodeoxyglucose positron emission tomography and computed tomography and magnetic resonance imaging in oral cavity squamous cell carcinoma with palpably negative neck. J Clin Oncol 2006;24:4371–6CrossRefGoogle ScholarPubMed
8Ng, SH, Yen, TC, Liao, CT, Chang, JT, Chan, SC, Ko, SF et al. 18F-FDG PET and CT/MRI in oral cavity squamous cell carcinoma: a prospective study of 124 patients with histologic correlation. J Nucl Med 2005;46:1136–43Google ScholarPubMed
9Ng, SH, Joseph, CT, Chan, SC, Ko, SF, Wang, HM, Liao, CT et al. Clinical usefulness of 18F-FDG PET in nasopharyngeal carcinoma patients with questionable MRI findings for recurrence. J Nucl Med 2004;45:1669–76Google ScholarPubMed
10Liu, SH, Chang, JT, Ng, SH, Chan, SC, Yen, TC. False positive fluorine-18 fluorodeoxy-D-glucose positron emission tomography finding caused by osteoradionecrosis in a nasopharyngeal carcinoma patient. Br J Radiol 2004;77:257–60CrossRefGoogle Scholar
11Ho, CL. Clinical PET imaging – an Asian perspective. Ann Acad Med Singapore 2004;33:155–65CrossRefGoogle ScholarPubMed
12Cerfolio, RJ, Bryant, AS, Ohja, B, Bartolucci, AA, Eloubeidi, MA. The accuracy of endoscopic ultrasonography with fine-needle aspiration, integrated positron emission tomography with computed tomography, and computed tomography in restaging patients with esophageal cancer after neoadjuvant chemoradiotherapy. J Thorac Cardiovasc Surg 2005;129:1232–41CrossRefGoogle ScholarPubMed
13Eloubeidi, MA, Cerfolio, RJ, Chen, VK, Desmond, R, Syed, S, Ojha, B. Endoscopic ultrasound-guided fine needle aspiration of mediastinal lymph node in patients with suspected lung cancer after positron emission tomography and computed tomography scans. Ann Thorac Surg 2005;79:263–8CrossRefGoogle ScholarPubMed
14van den Brekel, MW, Castelijns, JA, Stel, HV, Luth, WJ, Valk, J, van der Waal, I et al. Occult metastatic neck disease: detection with US and US-guided fine-needle aspiration cytology. Radiology 1991;180:457–61CrossRefGoogle ScholarPubMed
15Yen, RF, Hong, RL, Tzen, KY, Pan, MH, Chen, TH. Whole-body 18F-FDG PET in recurrent or metastatic nasopharyngeal carcinoma. J Nucl Med 2005;46:770–4Google ScholarPubMed
16Wu, CH, Lee, MM, Huang, KC, Ko, JY, Sheen, TS, Hsieh, FJ. A probability prediction rule for malignant cervical lymphadenopathy using sonography. Head Neck 2000;22:223–83.0.CO;2-D>CrossRefGoogle ScholarPubMed
17Kramer, H, van Putten, JW, Post, WJ, van Dullemen, HM, Bongaerts, AH, Pruim, J et al. Oesophageal endoscopic ultrasound with fine needle aspiration improves and simplifies the staging of lung cancer. Thorax 2004;59:596–601CrossRefGoogle ScholarPubMed