17. Utility of Metabolic Imaging in Oral Squamous Cell Carcinoma (SCC) Staging. Experience in 30 Patients

Abstract

Purpose: SCC represents nearly 90% of all oral malignancies, with an increasing incidence. Accurate Tumour-Node-Metastasis staging (TNM) is mandatory for planning surgical options and chemotherapy-radiotherapy management. Positron Emission Tomography (PET) using ¹⁸F-Fluorodeoxyglucose (FDG) provides functional information about tumoral tissues that may improve preoperative staging obtained by conventional morphologic procedures (CT-MRI). The purpose of this study is to evaluate the accuracy of FDG-PET in oral SCC staging and to compare those data from conventional and PET studies according to the pathologic results obtained from surgical specimen.

Methods: A prospective study of 30 patients was carried out, through a 26 months period. Inclusion criteria include positive biopsy for Oral SCC, no other malignancies during the past 5 year and surgery as preferred therapeutic option. All patients underwent CT, MRI, and FDG-PET studies consecutively. Results obtained from conventional and PET preoperative staging were compared with those from postoperative histopathological studies

Results: FDG-PET modified preoperative staging obtained by conventional morphologic studies in 21% cases, which was confirmed postoperatively by histological findings. Kappa test showed higher values for PET studies (0.89) than conventional studies (0.41), when compared with postoperative control

Conclusion: FDG-PET may be helpful to improve the accuracy of conventional studies in oral SCC preoperative TNM staging, although no definitive conclusions can be withdrawn due to the limited size of the sample. Modifications of preoperative staging showed by PET are a matter of controversy and must be kept in mind for further studies.