This study assessed the role of 18F-FDG PET-CT (PET/CT) to detect the cartilage and paraglottic infiltration in advanced glottic cancer comparing the results with those of conventional imaging (CI) (contrast-enhanced computed tomography and/or magnetic resonance). In addition, we assessed the prognostic value of quantitative parameters, measured on baseline PET/CT, in terms of event-free survival (EFS) and overall survival (OS). We retrospectively analyzed 27 patients with glottic squamous cell carcinoma stage III and IVA, treated in our institute between 2010 and 2016, comparing PET/CT, performed for staging and radiotherapy planning, and CI findings. Cohen's K was used to compare concordance between PET/CT and CI. Imaging findings were correlated with endoscopic evaluation and histological reports (gold standard (GS)). All lesions shown by CI were also detected by PET/CT imaging, and in 5 cases, a better definition of local infiltration was achieved with PET/CT than CI (5 CT). Sensitivity, specificity, and accuracy of PET/CT and CT were 95%, 86%, and 93% and 70%, 86%, and 74% for, respectively. MRI showed sensitivity and specificity of 100%. One false-negative (FN) cases and 1 false-positive (FP) case were observed with PET/CT with no difference compared to MRI (10 cases). Six FN cases and 1 FP case were observed with CT. Cohen's K was 0.60 (PET vs. CI) and 0.80 (PET vs. GS). Patients were followed-up for at least 24 months to calculate EFS and OS. 13 local recurrence and 7 deaths were recorded. Among quantitative PET parameters, baseline MTV was the most powerful predictor of outcome. Our data suggest a reliable sensitivity and accuracy of PET/CT in the evaluation of local extension, proving a useful method for initial local staging in addition to the well-established role in lymph-node and distant sites assessment. Furthermore, pretreatment MTV provides better prognostic information than other PET/CT parameters.

中文翻译：

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晚期声门癌的18F-FDG-PET / CT成像：与常规成像比较的临床决策工具。

这项研究评估了18F-FDG PET-CT（PET / CT）在检测晚期声门癌中的软骨和声门旁浸润中的作用，并将结果与​​常规成像（CI）（对比增强的计算机断层扫描和/或磁共振）相比较）。此外，我们根据无事件生存期（EFS）和总体生存期（OS）评估了在基线PET / CT上测得的定量参数的预后价值。我们回顾性分析了2010年至2016年间在我院接受治疗的27例声门鳞状细胞癌III期和IVA患者，比较了PET / CT，分期和放疗计划以及CI结果。Cohen的K用于比较PET / CT和CI之间的一致性。影像学发现与内镜评估和组织学报告（金标准（GS））相关。通过PET / CT成像还可以检测到CI显示的所有病变，在5例中，PET / CT可以比CI（5 CT）更好地定义局部浸润。PET / CT和CT的敏感性，特异性和准确性分别为95％，86％和93％，以及70％，86％和74％。MRI显示敏感性和特异性为100％。PET / CT观察到1例假阴性（FN）和1例假阳性（FP），与MRI（10例）相比无差异。CT观察到6例FN病例和1例FP病例。科恩的K为0.60（PET对CI）和0.80（PET对GS）。对患者进行至少24个月的随访，以计算EFS和OS。记录了13例局部复发和7例死亡。在定量PET参数中，基线MTV是最有力的预后指标。我们的数据表明，PET / CT在评估局部扩展方面具有可靠的敏感性和准确性，除了在淋巴结和远处评估中已确立的作用外，还证明了初步的局部分期的有用方法。此外，与其他PET / CT参数相比，预处理MTV可提供更好的预后信息。