Document Detail


Does 18F-FDG PET/CT improve the detection of posttreatment recurrence of head and neck squamous cell carcinoma in patients negative for disease on clinical follow-up?
MedLine Citation:
PMID:  19091901     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Posttreatment surveillance for the recurrence of head and neck squamous cell carcinoma (HNSCC) is a diagnostic challenge. Tissue distortion from radiation and surgery can obscure early detection of recurrence by conventional follow-up approaches such as physical examination, CT, and MRI. Several studies have shown that 18F-FDG PET may be an effective technique for the detection of persistent, recurrent, and distant metastatic HNSCC after treatment. The aim of this prospective study was to determine the benefits of hybrid 18F-FDG PET/CT in detecting a subclinical locoregional recurrence of HNSCC and distant metastases. The study patients were considered cured of HNSCC on the basis of 12 mo of negative findings on conventional follow-up. We also assessed the diagnostic accuracy of 18F-FDG PET/CT in these patients. METHODS: Ninety-one patients cured of HNSCC without any clinical evidence of recurrence were included. Whole-body 18F-FDG PET/CT examination was performed 11.6+/-4.4 mo after the end of the treatment. The gold standard was histopathology or 6 mo of imaging follow-up. RESULTS: The whole-body 18F-FDG PET/CT examinations had negative results in 52 patients and positive results in 39. Nine of these patients who exhibited abnormal 18F-FDG uptake in the head and neck area did not have recurrent HNSCC (false-positive). Thirty had proven recurrence. The sensitivity and specificity of 18F-FDG PET/CT in this study for the diagnosis of HNSCC recurrence were 100% (30/30) and 85% (52/61), respectively. The positive predictive value was 77% (30/39). The negative predictive value was 100% (52/52). The overall accuracy was 90% (82/91). CONCLUSION: The results of our study confirm the high effectiveness of 18F-FDG PET/CT in the assessment of HNSCC recurrence and suggest that 18F-FDG PET/CT is more accurate than conventional follow-up physical examination alone in the assessment of recurrence after previous curative treatment for HNSCC and could be proposed systematically at 12 mo of the usual follow-up.
Authors:
Ronan Abgral; Solène Querellou; Gaël Potard; Pierre-Yves Le Roux; Alexandra Le Duc-Pennec; Remi Marianovski; Olivier Pradier; Yves Bizais; Françoise Kraeber-Bodéré; Pierre Y Salaun
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-12-17
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  50     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-01-13     Completed Date:  2009-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-9     Citation Subset:  IM    
Affiliation:
Nuclear Medicine Department, University Hospital of Brest, Brest, France.
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MeSH Terms
Descriptor/Qualifier:
Carcinoma, Squamous Cell / diagnosis*,  pathology,  therapy*
False Negative Reactions
Female
Fluorodeoxyglucose F18 / diagnostic use*
Follow-Up Studies
Head and Neck Neoplasms / diagnosis*,  pathology,  therapy*
Humans
Male
Middle Aged
Neoplasm Metastasis / diagnosis
Neoplasm Recurrence, Local / diagnosis*
Positron-Emission Tomography
Sensitivity and Specificity
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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