F-Fluorodeoxyglucose positron emission tomography [F-FDG PET CT] in assessment of patients with vocal cord paralysis [VCP] secondary to extra laryngeal neoplastic causes: How is it reliable?
Egyptian Journal of Radiology and Nuclear Medicine, ISSN: 2090-4762, Vol: 55, Issue: 1
2024
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Research from Ain Shams University Provides New Study Findings on Vocal Cord Paralysis (18F-Fluorodeoxyglucose positron emission tomography [18F-FDG PET CT] in assessment of patients with vocal cord paralysis [VCP] secondary to extra laryngeal ...)
2024 MAR 18 (NewsRx) -- By a News Reporter-Staff News Editor at Cancer Daily -- New study results on vocal cord paralysis have been published.
Article Description
Background: The main cause of voice hoarseness is vocal cord palsy (VCP) that may be induced by many diseases that could be due to local laryngeal or extra laryngeal causes, including neoplastic and non-neoplastic entities. Normal vocal cords F-fluorodeoxyglucose (FDG) activity should be symmetric and of low grade higher than the mediastinal background uptake. Vocal cords asymmetrical FDG uptake was a well-known finding in patients with VCP. When recurrent laryngeal nerve (RLN) palsy is suspected, FDG PET and computed tomography (CT) findings can give strong evidence of diagnosis, with ability to diagnose the underlying extra laryngeal neoplastic etiology. Our aim was to assess the sensitivity and accuracy of hybrid FDG PET CT scan in diagnosis of VCP secondary to an extra laryngeal neoplastic cause. Methods: A retrospective study for 50 patients, presented with hoarseness of voice, referred from Otorhinolaryngology department to outpatient clinical oncology units, with clinically suspected extra laryngeal neoplastic causes of VCP. Left lung cancer was detected in 52% of patients which was the most frequent cause, 10% had right lung cancer, 8% had thyroid cancer, 6% had mediastinal lymphoma, 6% had metastatic mediastinal lymph nodes from breast cancer, and 6% had esophageal carcinoma. Results: PET CT scan versus CT scan showed true positive results in (44 vs. 29 patient), true negative results in 5 patients in both scans, and false negative in (1 vs. 16 patient), with no false positive in either. Thus, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for PET CT scan versus CT scan were 98% vs. 68%, 100% for both scans, 100% for both scans, 83.3% vs. 23.8%, and 86% vs. 56%, respectively. Conclusions: FDG PET CT scan plays an important role in diagnosis of oncology-related extra laryngeal causes of VCP, with higher sensitivity, negative predictive value, and accuracy than CT scan. FDG PET CT scan should be included in the workup of VCP if extra laryngeal oncological cause is suspected.
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Springer Science and Business Media LLC
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