{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T11:14:24Z","timestamp":1783422864286,"version":"3.54.6"},"reference-count":53,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Limited research has been done previously in examining the utility of PET\/CT in the preoperative staging of betel nut associated OSCC (BNOSCC). This study was conducted to evaluate the relationship between the standardized uptake values (SUV) of lymph nodes via FDG-PET\/CT and their corresponding pathological specimens in betel nut chewers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design:<\/jats:title>\n                    <jats:p>Retrospective review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Single-institution academic center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of patients with BNOSCC seen at the Tipler Army Medical Center (TAMC) Head and Neck Surgery clinic from October 2004 to October 2019 was conducted. Preoperative FDG-PET\/CT images were analyzed for the SUVmax of regional lymph nodes, with a node positive for malignancy defined as &gt;3. The extent of disease spread predicted by FDG-PET\/CT was then compared to the postoperative histopathological results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among patients with BNOSCC, FDG-PET\/CT was found to significantly overpredict the extent of lymph node involvement identified on pathological analysis. Metabolic activity of lymph nodes was significantly overestimated on preoperative imaging. These findings highlight a clear discrepancy between the sensitivity and specificity of FDG-PET\/CT found in BNOSCC and that in non-betel nut related disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Elevated false-positive rates for LN positivity on FDG-PET\/CT have been observed in BNOSCC patients. This finding could potentially lead to upstaging, and lead to excessive, more invasive treatment courses and interventions. This is a phenomenon that Head and Neck surgeons should be cautious about when working with BNOSCC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence:<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00034894261427917","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T06:34:21Z","timestamp":1774938861000},"page":"572-579","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Limitations of PET\/CT in Detecting Cervical Lymph Node Metastases in Betel Nut Induced Oral Cancer"],"prefix":"10.1177","volume":"135","author":[{"given":"Kurtis","family":"Young","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery, University of Nevada, Las Vegas, NV, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeeba F.","family":"Ghias","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology \u2013 Head and Neck Surgery, Tripler Army Medical Center, Honolulu, HI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Fancher","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Southern California Medical Center, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong Jun","family":"Ahn","sequence":"additional","affiliation":[{"name":"University of Hawai\u2019i at M\u0101noa, John A. 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