Clinical value of (18)F-FDG-PET/CT in staging cutaneous squamous cell carcinoma Journal Article


Authors: Mahajan, S.; Barker, C. A.; Singh, B.; Pandit-Taskar, N.
Article Title: Clinical value of (18)F-FDG-PET/CT in staging cutaneous squamous cell carcinoma
Abstract: BackgroundCutaneous 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 (18F-FDG)-PET is not clearly established. In this study, we evaluated 18F-FDG-PET/CT imaging for initial staging of cSCC.Patients and methods18F-FDG-PET/CT scans performed in patients with newly diagnosed cSCC were reviewed retrospectively. Images were visually assessed for lesions and 18F-FDG uptake [standardized uptake value (SUV)] in primary and secondary sites was measured. Suspected lesions on 18F-FDG-PET/CT were correlated with histopathology when available, follow-up imaging or clinical data in others.ResultsTwenty-three cSCC patients who underwent 18F-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 18F-FDG-positive scans with a total of 51 18F-FDG-positive lesions. All primary lesions (n=24) were 18F-FDG-positive (SUV: 2.3-22.8; mean 10.2), and additional 27 18F-FDG-positive lesions, including 21 nodes, four cutaneous, one osseous and one lung lesion, were noted in 13 patients. Mean size of 18F-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 18F-FDG-PET/CT scan were 100, 77.5, and 77.5%, respectively. 18F-FDG detected seven additional lesions in three patients, compared to CT/MRI. Overall, staging 18F-FDG-PET/CT detected nine prior unknown lesions in five patients that were proven metastatic disease by histopathology or follow-up; 18F-FDG-PET/CT modified management in 5/23 (21.7%) patients.Conclusion18F-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. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: squamous cell carcinoma; staging; lymphatic metastasis; neoplasm; neoplasms; skin; cutaneous; pet; fluorine-18-fluorodeoxyglucose
Journal Title: Nuclear Medicine Communications
Volume: 40
Issue: 7
ISSN: 0143-3636
Publisher: Lippincott Williams & Wilkins  
Date Published: 2019-07-01
Start Page: 744
End Page: 751
Language: English
DOI: 10.1097/mnm.0000000000001029
PUBMED: 31095044
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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MSK Authors
  1. Bhuvanesh Singh
    218 Singh
  2. Christopher Barker
    143 Barker
  3. Sonia Mahajan
    14 Mahajan