Diagnostic efficacy of positron emission computerized tomography scans in suspicious laryngeal findings postorgan preservation treatment

Head Neck. 2023 Jan;45(1):207-211. doi: 10.1002/hed.27227. Epub 2022 Oct 27.

Abstract

Background: Larynx preservation protocols (LPP) for glottic primary squamous cell carcinoma has gained popularity worldwide. Direct laryngoscopy (DL) with biopsy is mandated when recurrence is suspected. The efficacy of 18Fluoro-deoxy-glucose positron emission computerized tomography (PET-CT) as alternative first-line diagnostic investigation in suspected recurrence was evaluated.

Methods: A retrospective study of patients with suspicious fiber-optic findings at more than 12 weeks after LPP. Sensitivity, specificity, and the negative predictive value (NPV) of DL and PET-CT were compared.

Results: Seventy-two patients presenting 105 cases of suspicious events were included in this study. Fifty-two events were initially investigated by DL and 53 events by PET-CT. The sensitivity of DL and PET-CT was 56.25% and 100%, respectively. The NPV was 84% for DL and 100% for PET-CT (p = 0.015).

Conclusion: Negative PET scans after LPP are highly accurate in ruling out recurrent/persistent disease and may spare the patient from negative biopsies.

Keywords: direct laryngoscopy; follow-up; larynx; positron emission tomography scan.

MeSH terms

  • Fluorodeoxyglucose F18
  • Head and Neck Neoplasms*
  • Humans
  • Larynx* / diagnostic imaging
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Positron Emission Tomography Computed Tomography / methods
  • Positron-Emission Tomography / methods
  • Radiopharmaceuticals
  • Retrospective Studies
  • Sensitivity and Specificity
  • Squamous Cell Carcinoma of Head and Neck

Substances

  • Fluorodeoxyglucose F18
  • Radiopharmaceuticals