Positron emission tomography in surveillance of head and neck squamous cell carcinoma after definitive chemoradiotherapy

Head Neck. 2009 Apr;31(4):442-51. doi: 10.1002/hed.20978.

Abstract

Background: We assessed the role of (18)F-fluoro-deoxy-glucose positron emission tomography (PET) in detecting head and neck squamous cell carcinoma (HNSCC) after definitive chemoradiotherapy (CRT).

Methods: A prospective study presented 80 PET before and after CRT for 44 patients, including 44 first-time post-CRT scans performed between 12 and 17 weeks after radiotherapy completion, as well as 10 repeated scans in the subsequent follow-up. PET interpretations were compared with clinicopathologic outcomes.

Results: PET demonstrated better performance than CT in post-CRT surveillance. Considering all 54 post-CRT PET scans, sensitivity for detecting primary tumors was 100%, specificity 93%, positive predictive value (PPV) 80%, and negative predictive value (NPV) 100%. For cervical diseases, sensitivity was 100%, specificity 98%, PPV 92%, and NPV 100%. For distant metastases, sensitivity was 100%, specificity 98%, PPV 86%, and NPV 100%.

Conclusions: Negative PET readings were reliable for predicting free of HNSCC and helpful for selected patients in post-CRT surveillance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / diagnostic imaging*
  • Carcinoma, Squamous Cell / therapy
  • Combined Modality Therapy
  • Female
  • Fluorodeoxyglucose F18
  • Head and Neck Neoplasms / diagnostic imaging*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neck
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Radiopharmaceuticals
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18