Evaluation with Neck MRI in Patients with FDG Uptake in the Vocal Cords on PET/CT

Abstract

Background/Aims: Elevated fluorodeoxyglucose (FDG) uptake in the vocal cords observed on PET/CT scans may result from tumors, vocal cord paralysis, inflammation, or normal phonatory activity. Therefore, cervical MRI is valuable for assessing the anatomical correlates underlying these metabolic changes in clinical practice. Methods: A retrospective cross-sectional study was performed involving patients with elevated FDG uptake in the vocal cords on PET/CT scans from 2020 to 2025. Patients with head and neck cancers or MRI scans with artifacts were excluded. Cervical MRI results from 38 PET-positive patients were compared with those of a control group of 17 individuals without vocal cord uptake. The apparent diffusion coefficient (ADC) was measured for both vocal cords, and vocal cord-to-muscle signal intensity ratios were calculated on T1- and T2-weighted images. Demographic, clinical, and imaging data were analyzed using appropriate statistical tests. Results: The study included 38 patients and 17 controls. No significant differences were observed between the groups in SUVmax, ADC, or T1/T2 signal intensity ratios. No strong associations were identified between underlying conditions, sex, MRI findings, or history of chemotherapy or radiotherapy and the imaging parameters. However, age demonstrated a moderate positive correlation with ADC values in the right vocal cord and a weak-to-moderate correlation in the left vocal cord. Conclusion: Increased FDG uptake in the vocal cords on PET/CT cannot be reliably identified using quantitative MRI measurements alone. These data indicate that comprehensive anatomical assessment, clinical evaluation, and endoscopic examination, when indicated, are necessary for interpreting vocal cord FDG uptake rather than relying solely on MRI metrics.

Keywords

• FDG PET/CT
• Vocal cord
• Vocal cord paralysis
• Neck MRI
• Apparent diffusion coefficient

Supporting Institution

There are no sources of funding to declare.

Ethical Statement

For studies involving humans, please incorporate the following statement: "The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board (or Ethics Committee) of [ANKARA DR AY ONCOLOGY EDUCATION AND RESEARCH HOSPITAL] (2025-12/187).

Thanks

The authors thank the relevant institutional units for their support in accessing the imaging archive and during the data-management process.

PET/BT’de Vokal Kordlarda FDG Tutulumu Saptanan Hastaların Boyun MRG ile Değerlendirilmesi

Abstract

Amaç: PET/BT incelemelerinde vokal kordlarda izlenen artmış florodeoksiglukoz (FDG) tutulumu tümör, vokal kord paralizisi, inflamasyon veya fizyolojik fonatuvar aktiviteye bağlı olabilir. Bu nedenle servikal MRG, klinik pratikte bu metabolik değişikliklerin anatomik karşılığını değerlendirmek açısından değerlidir. Gereç ve Yöntem: Bu retrospektif kesitsel çalışmada, 2020-2025 yılları arasında PET/BT incelemelerinde vokal kordlarda artmış FDG tutulumu saptanan hastalar değerlendirildi. Baş-boyun kanseri olan hastalar ve artefaktlı MRG incelemeleri dışlandı. Otuz sekiz PET-pozitif hastanın servikal MRG bulguları, vokal kord tutulumu olmayan 17 kişilik kontrol grubu ile karşılaştırıldı. Her iki vokal kord için görünür difüzyon katsayısı (ADC) ölçüldü ve T1- ve T2-ağırlıklı görüntülerde vokal kord-kas sinyal intensite oranları hesaplandı. Demografik, klinik ve görüntüleme verileri uygun istatistiksel testlerle analiz edildi. Bulgular: Çalışmaya 38 hasta ve 17 kontrol hastası dahil edildi. Gruplar arasında SUVmax, ADC veya T1/T2 sinyal intensite oranları açısından anlamlı fark saptanmadı. Altta yatan hastalık, cinsiyet, MRG bulguları veya kemoterapi/radyoterapi öyküsü ile görüntüleme parametreleri arasında güçlü bir ilişki izlenmedi. Bununla birlikte yaş, sağ vokal kord ADC değerleri ile orta düzeyde, sol vokal kord ADC değerleri ile zayıf-orta düzeyde pozitif korelasyon gösterdi. Sonuç: PET/BT'de vokal kordlarda artmış FDG tutulumu yalnızca kantitatif MRG ölçümleri ile güvenilir biçimde ayırt edilemeyebilir. Bu veriler, vokal kord FDG tutulumunun yorumlanmasında yalnızca MRG bulgularına dayanmak yerine kapsamlı anatomik değerlendirme, klinik değerlendirme ve gerektiğinde endoskopik incelemenin gerekli olduğunu göstermektedir.

Keywords

• FDG PET/BT
• Vokal kord
• Vokal kord paralizisi
• Boyun MRG
• Apparent diffusion coefficient

Supporting Institution

Beyan edilecek herhangi bir finansman kaynağı bulunmamaktadır.

Ethical Statement

Bu çalışma Helsinki Bildirgesi ilkelerine uygun olarak yürütülmüş ve Ankara Dr. Abdurrahman Yurtaslan Onkoloji Eğitim ve Araştırma Hastanesi Etik Kurulu tarafından onaylanmıştır (Karar No: 2025-12/187).

Thanks

Yazarlar, görüntüleme arşivine erişim ve veri yönetimi sürecindeki destekleri için ilgili kurumsal birimlere teşekkür eder.

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