Vol 24, No 2 (2021)
Research paper
Published online: 2021-07-30

open access

Page views 6646
Article views/downloads 562
Get Citation

Connect on Social Media

Connect on Social Media

Value of [18F]FDG PET-CT in the follow-up of surgically treated oral tongue squamous cell carcinoma: single centre cohort analysis on 87 patients

Marco Ravanelli1, Alberto Grammatica2, Guido Squassina1, Francesco Bertagna3, Domenico Albano3, Davide Lancini2, Paolo Bosio2, Angelo Zigliani1, Giorgio Maria Agazzi1, Roberto Maroldi1, Piero Nicolai4, Raffaele Giubbini3, Cesare Piazza2, Davide Farina1
Pubmed: 34382669
Nucl. Med. Rev 2021;24(2):58-62.


Background: To evaluate the diagnostic performance of [18F]fluorodeoxyglucose positron emission tomography/computed tomography ([18F]FDG-PET/CT) scan in detecting local recurrences in patients with surgically treated oral tongue squamous cell cancer (OTSCC).

Material and methods: Eighty-seven patients who had undergone surgery for OTSCC were monitored clinically and [18F]FDGPET/CT and magnetic resonance (MR). PET uptakes were classified as functional (Type A), suspicious (Type B), or highly suggestive of local recurrence (Type C). A multidisciplinary team (MDT) evaluated case-by-case the surveillance strategy based on PET uptake.

Results: Fifty-nine patients presented FDG-PET uptake during follow-up: this report was significantly more frequent in patients who received flap reconstruction than in those without (73% vs 50%; p = 0.05). In 13 patients with Type A (n = 1), Type B (n = 9), and Type C (n = 3) uptakes an additional MR was considered preferable and discovered recurrence in 12.PET-CT had 9 true positives, 17 false positives, 71 true negatives, and no false-negative, resulting in sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of 100%, 80.7%, 34.6%, and 100%.

Conclusions: The present results demonstrated a change in diagnostic strategy, as decided by the MDT, in about one-fifth of patients. The results should prompt in designing a rational surveillance schedule in surgically treated OTSCC.

Article available in PDF format

View PDF Download PDF file


  1. Myers JN, Elkins T, Roberts D, et al. Squamous cell carcinoma of the tongue in young adults: increasing incidence and factors that predict treatment outcomes. Otolaryngol Head Neck Surg. 2000; 122(1): 44–51.
  2. Annertz K, Anderson H, Biörklund A, et al. Incidence and survival of squamous cell carcinoma of the tongue in Scandinavia, with special reference to young adults. Int J Cancer. 2002; 101(1): 95–99.
  3. Paderno A, Morello R, Piazza C. Tongue carcinoma in young adults: a review of the literature. Acta Otorhinolaryngol Ital. 2018; 38(3): 175–180.
  4. Chong V. Oral cavity cancer. Cancer Imaging. 2005; 5 Spec No A: S49–S52.
  5. Brierley JD, Gospodarowicz MK, Wittekind CT. TNM classification of malignant tumours - 8th edition. Wiley-Blackwell, Oxford 2017.
  6. Calabrese L, Bruschini R, Giugliano G, et al. Compartmental tongue surgery: Long term oncologic results in the treatment of tongue cancer. Oral Oncol. 2011; 47(3): 174–179.
  7. Piazza C, Grammatica A, Montalto N, et al. Compartmental surgery for oral tongue and floor of the mouth cancer: Oncologic outcomes. Head Neck. 2019; 41(1): 110–115.
  8. Piazza C, Montalto N, Paderno A, et al. Is it time to incorporate 'depth of infiltration' in the T staging of oral tongue and floor of mouth cancer? Curr Opin Otolaryngol Head Neck Surg. 2014; 22(2): 81–89.
  9. Calabrese L, Giugliano G, Bruschini R, et al. Compartmental surgery in tongue tumours: description of a new surgical technique. Acta Otorhinolaryngol Ital. 2009; 29(5): 259–264.
  10. Tagliabue M, Gandini S, Maffini F, et al. The role of the T-N tract in advanced stage tongue cancer. Head Neck. 2019; 41(8): 2756–2767.
  11. Sarrión Pérez MG, Bagán JV, Jiménez Y, et al. Utility of imaging techniques in the diagnosis of oral cancer. J Craniomaxillofac Surg. 2015; 43(9): 1880–1894.
  12. Paiva RR, Figueiredo PT, Leite AF, et al. Oral cancer staging established by magnetic resonance imaging. Braz Oral Res. 2011; 25(6): 512–518.
  13. Rajesh A, Khan A, Kendall C, et al. Can magnetic resonance imaging replace single photon computed tomography and computed tomography in detecting bony invasion in patients with oral squamous cell carcinoma? Br J Oral Maxillofac Surg. 2008; 46(1): 11–14.
  14. Burkill GJC, Evans RM, Raman VV, et al. Modern radiology in the management of head and neck cancer. Clin Oncol (R Coll Radiol). 2016; 28(7): 440–450.
  15. Murakami R, Shiraishi S, Yoshida R, et al. Reliability of MRI-derived depth of invasion of oral tongue cancer. Acad Radiol. 2019; 26(7): e180–e186.
  16. Fenton M, Foote RL, Gillison ML, et al. NCCN Guidelines Version 1.2019 Head and Neck Cancers. www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf.
  17. Oda M, Tanaka T, Kito S. Recent advances of the diagnostic images for oral cancers. In: Harris S. ed. Oral cancer: causes, diagnosis and treatment, 1st ed. Nova Science Publishers, New York 2011.
  18. Mehanna H, Wong WL, McConkey CC, et al. PET-NECK Trial Management Group. PET-CT surveillance versus neck dissection in advanced head and neck cancer. N Engl J Med. 2016; 374(15): 1444–1454.
  19. Müller J, Hüllner M, Strobel K, et al. The value of (18) F-FDG-PET/CT imaging in oral cavity cancer patients following surgical reconstruction. Laryngoscope. 2015; 125(8): 1861–1868.
  20. Haerle SK, Hany TF, Ahmad N, et al. Physiologic [18F]fluorodeoxyglucose uptake of floor of mouth muscles in PET/CT imaging: a problem of body position during FDG uptake? Cancer Imaging. 2013; 13(1): 1–7.