Primary and recurrent early stage laryngeal cancer: Preliminary results of2-[fluorine 18]fluoro-2-deoxy-D-glucose PET imaging

PURPOSE: To evaluate the effectiveness of 2-[fluorine 18]fluoro-2-deoxy-D-g lucose (FDG) positron emission tomography (PET) in the identification of ea rly stage (T1-T2) primary and recurrent laryngeal cancer. MATERIALS ANP METHODS: Twelve patients with T1 or T2 laryngeal cancer under went imaging prospectively with PET. Seven patients had new disease, and fi ve had recurrent disease, All patients underwent imaging prior to planned t herapy and tissue biopsy. PET images were evaluated by using standardized u ptake ratios and visual analysis. RESULTS: Histopathologic evidence of early stage cancer was documented,in t he 12 patients. One had a carcinoma in situ, nine had T1 tumors, and two ha d T2 tumors. Of the 12 patients, 10 had vocal cord tumors, one had a hypoph aryngeal tumor, and one had a preepiglottic tumor. Eleven (92%) patients wi th early stage cancer had standardized uptake ratios indicative of malignan cy:(mean, 4.6; SD, 1.8; 95% CI, 1.2; range, 2.8-7.6). One had false-negativ e 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 sta ge laryngeal cancer. It may be useful for follow-up after therapy.