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Primary and Recurrent Early Stage Laryngeal Cancer: Preliminary Results of 2-[Fluorine 18]fluoro-2-deoxy-D-glucose PET Imaging¹

¹ From the Departments of Nuclear Medicine (V.J.L., J.W.F.), Radiation Oncology (H.K.), Otolaryngology-Head and Neck Surgery (J.H.B., J.F.E.), and Hematology/Oncology (F.R.D.), PET Imaging Facility, St Louis University Health Sciences Center, 3635 Vista Ave at Grand Blvd, St Louis, MO 63110-0250. From the 1997 RSNA scientific assembly. Received April 15, 1998; revision requested May 29; final revision received December 16; accepted March 16, 1999. Address reprint requests to V.J.L. (e-mail: lowe@nucmed.slu.edu).

PURPOSE: To evaluate the effectiveness of 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in the identification of early stage (T1–T2) primary and recurrent laryngeal cancer.

MATERIALS AND METHODS: Twelve patients with T1 or T2 laryngeal cancer underwent imaging prospectively with PET. Seven patients had new disease, and five had recurrent disease. All patients underwent imaging prior to planned therapy and tissue biopsy. PET images were evaluated by using standardized uptake ratios and visual analysis.

RESULTS: Histopathologic evidence of early stage cancer was documented in the 12 patients. One had a carcinoma in situ, nine had T1 tumors, and two had T2 tumors. Of the 12 patients, 10 had vocal cord tumors, one had a hypopharyngeal tumor, and one had a preepiglottic tumor. Eleven (92%) patients with early stage cancer had standardized uptake ratios indicative of malignancy (mean, 4.6; SD, 1.8; 95% CI, 1.2; range, 2.8–7.6). One had false-negative results (standardized uptake ratio = 2.3). Nine underwent CT, and results in the larynx were normal in seven and abnormal in two.

CONCLUSION: FDG PET can be used to identify primary and recurrent early stage laryngeal cancer. It may be useful for follow-up after therapy.

Index terms: Emission CT (ECT), comparative studies, 27.12163 • Fluorine, radioactive • Head and neck neoplasms, CT, 27.12115, 27.37 • Head and neck neoplasms, emission CT (ECT), 27.12163, 27.37 • Larynx, neoplasms, 27.37

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