Detection of unknown primary tumours and distant metastases in patients with cervical metastases: Value of FDG-PET versus conventional modalities

Gerreke Regelink, Jolijn Brouwer, Remco De Bree, Jan Pruim, Bernard F. Van Der Laan, Willem Vaalburg, Otto S. Hoekstra, Emile F. Comans, Arjan Vissink, René C. Leemans, Jan L. Roodenburg

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In 1%-2% of head and neck oncology patients, the only symptom of a malignancy is a positive cervical node. The aim of this study was to compare the value of positron emission tomography using fluorine-18 fluoro-2-deoxy-D-glucose (FDG-PET) and conventional diagnostic modalities (CT and/or MRI, panendoscopy) in detecting unknown primary tumours and distant metastases in patients suffering from such a cervical metastasis. Fifty patients (37 men and 13 women) with cervical metastases of an unknown primary tumour were included. All patients underwent FDG-PET. In addition, CT and/or MRI was obtained and panendoscopy was performed. All clinically known metastases were detected by FDG-PET. The primary tumour could be diagnosed in 16 patients (four primary tumours were detected exclusively by FDG-PET). Seven patients had multiple distant metastases, that in six cases were detected exclusively by FDG-PET. The sensitivity and specificity of FDG-PET for detection of unknown primary tumours were 100% and 94%, respectively. For the conventional diagnostic modalities these values were 92% and 76%. FDG-PET had an exclusive effect on the applied therapy in 20% of the patients referred for diagnosis of an unknown primary tumour. The data obtained in this study strongly support the diagnostic strategy of performing FDG-PET in patients suffering from cervical metastases of an unknown primary tumour before any other diagnostic technique.

Original languageEnglish
Pages (from-to)1024-1030
Number of pages7
JournalEuropean journal of nuclear medicine
Issue number8
Publication statusPublished - 2002


  • Conventional imaging techniques
  • F-Fluoro-2-deoxy-D-glucose
  • Head and neck cancer
  • Positron emission tomography
  • Unknown primary tumour

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