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Scott W. Fosko, MD; Weimin Hu, MD, PhD; Thomas F. Cook, MD; Val J. Lowe, MD

Arch Dermatol. 2003;139:1141-1146.

Objective  To determine the ability of fluorodeoxyglucose F 18 positron emission tomography (FDG-PET) to image basal cell carcinoma (BCC).

Design  Case series study.

Setting  Mohs surgery practice in a tertiary university hospital.

Patients  Six patients with BCC larger than 1.0 cm of the head and neck region were identified.

Results  Patients were imaged using FDG-PET before surgery. In 3 patients, PET imaging correlated well with the size and extent of the soft tissue invasion. Histologically, all 3 tumors were of the nodular subtype. The remaining 3 patients failed to demonstrate identifiable tumor activity on PET. Two of these 3 tumors were of the infiltrative histologic subtype, and 1 was of the nodular subtype. Perineural spread was detected by tissue biopsy in 1 infiltrative tumor, but not by FDG-PET imaging.

Conclusions  In our study, FDG-PET imaging was able to image and identify BCC in the head and neck region in 3 of 6 patients. In some cases, anatomic accuracy and the extent of soft tissue invasion were observed. The histologic subtype of the BCC appears to affect the ability of FDG-PET detection, with the nodular histologic subtype more likely to test positive on PET. This is a preliminary study, and future investigation is needed to evaluate the role of PET imaging in the management of patients with BCC.

From the Department of Dermatology, Saint Louis University Health Sciences Center (Drs Fosko and Cook), and Saint Louis University School of Medicine (Dr Hu), St Louis, Mo; and Department of Radiology, Mayo Clinic, Rochester, Minn (Dr Lowe). Dr Hu is now with the Department of Dermatology, Case Western Reserve University, Cleveland, Ohio. Dr Cook is now in private practice in Visalia, Calif. The authors have no relevant financial interest in this article.

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