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Role of Whole body PET/CT and Examination under anesthesia with multi-site biopsy in evaluating CUP.
- Source :
-
Indian Journal of Otolaryngology & Head & Neck Surgery . 2022 Suppl, Vol. 74, p2656-2662. 7p. - Publication Year :
- 2022
-
Abstract
- To evaluate the role of 18FDG-WBPET-CT, Examination under anesthesia (EUA), and multiple-site biopsy in detecting the occult site in head & neck carcinoma of unknown primary (HN-CUP). In this prospective study, 22 patients with diagnosed CUP, after a thorough outpatient endoscopic evaluation of upper airway and radiological evaluation (CT/MRI) that ruled out a primary lesion were included. These patients subsequently underwent whole-body PET-CT and EUA. Based on the presence of suspicious findings (+) or their absence (−) on 18FDG-WBPET-CT (P) and EUA (E), we divided the patients into 5 groups: P−E−, P−E + , P + E−, P + E + , and P + or E +. All these patients underwent bilateral palatine tonsillectomy, bilateral nasopharyngeal biopsy, and ipsilateral lingual tonsillectomy for identification of occult primary. Out of 22 patients, the primary could be detected in 4 patients (18%) after the workup (three in the oropharynx and one in the hypopharynx, all ipsilateral). 18FDG-PET-CT suspected primaries in 7 patients; biopsy was positive for three (sensitivity-75%, specificity-77%, PPV-43%, NPV-93%). Out of 5 patients, who had suspicious findings on EUA, 3 of the biopsies revealed malignancy (sensitivity-75%, specificity-88%, PPV-60%, NPV-94%). Both PET-CT and EUA when combined, yield a NPV of 100% if both are negative and PPV of 100% when both are positive for suspicious findings. No primary was identified in the absence of a suspicion by PET-CT or EUA. Without a suspicion on 18FDG-WBPET-CT and EUA, there is a limited role of multiple-site biopsies in patients of HN-CUP. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 22313796
- Volume :
- 74
- Database :
- Academic Search Index
- Journal :
- Indian Journal of Otolaryngology & Head & Neck Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 160422051
- Full Text :
- https://doi.org/10.1007/s12070-020-02268-z