PET-derived primary tumor volumes are substantially different from CT-derived tumor volumes, only decent correlation is noted between VolumeCT and Volume2.5. Volume2.5 and Volume50% seem to be reasonable alternatives for VolumeCT in predicting the patient outcomes.

Positron-emission tomography/computed tomography (PET/CT) has been proposed as a means to enhance the pretreatment evaluation of cervical lymph node status in patients with nasopharyngeal carcinoma (NPC). We conducted a prospective study to compare PET/CT and enhanced CT for the detection of retropharyngeal lymph node (RLN) metastasis in NPC, and to ascertain the factors that affect its diagnostic performance. Our study population was made up of 33 patients—24 men and 9 women, aged 30 to 81 years (mean: 52)—with newly diagnosed NPC who had been treated over a 2-year period. All patients underwent enhanced CT first, followed by unenhanced 18F-fluorodeoxyglucose (FDG) PET/CT. The detection rate of RLN metastasis on PET/CT was significantly lower than that on enhanced CT (36.4 vs. 75.8%; p < 0.001). A total of 25 of 26 nodes with a discordant finding were negative on PET/CT; they included 13 metastatic lymph nodes with low FDG uptake, 9 that were located close to the primary tumor, 2 that were confluent RLNs, and 1 that was adjacent to the physiologic FDG-avid prevertebral muscle. The maximum standardized uptake value (SUVmax) of RLNs was positively correlated with the minimum axial diameter (r = 0.803, p < 0.001). The PET/CT detection rate was 0% for lymph nodes smaller than 5 mm, 9% for those 5 to 10 mm, and 73% for those 1 cm or larger. The detection rate of PET/ CT at level C1 was significantly lower than that at C2 (22 vs. 67%; p = 0.035). We conclude that unenhanced PET/CT is markedly inferior to enhanced CT for detecting RLN metastasis in NPC, especially in lymph nodes with a minimum axial diameter of less than 1 cm and those in proximity to the primary tumor. Using enhanced CT in PET/CT is justified to improve the recognition of RLN metastasis in patients with NPC.

Positive and negative predictive values of PET examination before PND were 50% and 73%, respectively. None of the patients with PND experienced local or lymph node recurrence. Conclusion:Residual lymph nodes were frequently observed in head and neck carcinomas. Of the imaging tests, PET was sufficient for detecting residual regions. Although PND is a useful tool, related complications were frequently observed. A more accurate detection system is needed to reduce unnecessary neck dissections. Head and Neck SurgeryRetropharyngeal Node Metastasis in Nasopharyngeal Carcinoma Mu-Kuan Chen, MD (presenter); Iuan-Sheng We WuObjective: PET/CT has been proposed to enhance pretreatment evaluation of cervical nodal status in patients with nasopharyngeal carcinoma (NPC). The purpose of this study was to compare PET/CT and enhanced CT in the detection of retropharyngeal lymph node (RLN) metastasis in NPC, and to ascertain the factors affecting its diagnostic performance. Results:The detection rate of RLN metastasis on PET/CT was significantly lower than that on enhanced CT (36.4% vs 75.8%), Pmax of RLNs was positively correlated with the minimal axial diameter (r=0.803), P < 5 mm, 9% for those 5 to 10 mm, and 73% for those ≥1 cm. The detection rate of PET/CT at C1 level was significant lower than that at C2 level (22% vs 67%, P = .035), suggesting that RLNs in close proximity to the primary tumor hindered the recognition by PET/ CT. Conclusion:PET/CT is inferior to enhanced CT in detecting RLN metastasis in NPC, especially in lymph nodes with a diameter less than 1 cm or in close proximity to the primary tumor. Using enhanced CT in PET/CT is complementary in delineating the RLN metastasis in patients with NPC. Results: A total of 99 patients fulfilled the inclusion criteria (65 males and 34 females; median ages 59 and 71.5 years), IQR 47-74, and 53-81 years respectively). A total of 22 patients died between first presentation with FBI and the time of this study being conducted (mean follow up 34 months ±17). A total of two patients had recurrences but died before this study. For all other patients without recurrences the mean follow-up was 68 months ±20. Logistic regression demonstrated that only hiatus hernia demonstrated a statistical significance in its association with FBI recurrence (OR 4.77 95% CI 1.15-19.82, P = .032). All other variables were not statistically significant. Head and Neck Surgery Conclusion:The recurrence rate of food bolus impaction of the esophagus was 9%. Hiatus hernia was the only esophageal pathology associated with recurrence of food bolus impaction. Results: Presented 55 cases, aged between 23 and 86 years old, 56% male. A total of 75% were located at the parotid, 20% in the submandibular and 5% in minor salivary glands. Only 2 patients were not submitted to surgical excision. Most patients were in Stage II and IV. There were 12 (22%) adenoid cystic carcinoma, 10 (18%) mucoepidermoid carcinomas, 10 (18%) adenocarcinomas, 7 (13%) acinic cell carcinoma, and 16 (29%) of several other entities. A to...