DOI: 10.16899/jcm.1953686 ISSN: 2667-7180

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

Elif Aktaş, Erkan Bilgin, Ali Şahin, Ezel Yaltırık Bilgin, Felat Toprak, Gülin Uçmak
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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.

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