Abstract: Objective To investigate the predictive value of ¹⁸F-FDG SPECT imaging for the diagnosis of cervical lymph node metastasis cancer. Methods The clinical and pathological data of 46 suspected cervical lymph node metastasis cancer in our hospital from November,2015 to May,2016 were collected.All the patients underwent ¹⁸F-FDG SPECT scan and conventional imaging,and were all achieved pathological results.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of different screening method in the diagnosis of cervical lymph node metastasis cancer were compared.The maximum standardized uptake value (T/N) of focus in patients enrolled was measured and the ¹⁸F-FDG SPECT imaging characteristics of lymph node metastasis cancer were analyzed;The diagnostic value of different methods to check other metastasis focus were compared. Results The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ¹⁸F-FDG SPECT and conventional imaging for the primary lesion of cervical lymph node metastasis cancer were 87.5%,83.3%,87.0%,97.2%,50% and 70.0%,33.3%,65.2%,87.5%,14.28%,respectively;The average T/N of focus in patients with lymph node metastasis cancer was 7.15±3.51,while it in patients with non-metastatic lymph nodes cancer was 4.26±2.37,significantly lower than it in the lymph node metastasis cancer patients,the differences were statistically significant (P<0.05);The number of the lymph node and other metastatic focus detected by ¹⁸F-FDG SPECT were 10.24±3.47 and 1.58±1.64,while they detected by the conventional imaging were 6.18±4.38 and 0.62±0.48,significantly lower than the ¹⁸F-FDG SPECT,the differences were statistically significant (P<0.05). Conclusion ¹⁸F-FDG SPECT imaging have a higher diagnostic and predictive value for the cervical lymph node metastasis cancer,and can also find other metastases more efficiently.