| Identification of distant metastases with PET-CT in patients with suspected recurrent head and neck cancer. | |
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MedLine Citation:
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PMID: 19205017 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To investigate the utility of positron-emission tomography/computed tomography (PET-CT) in identifying distant metastatic disease in patients with suspected recurrent head and neck squamous cell cancer (HNSCC). STUDY DESIGN: Retrospective analysis. METHODS: Retrospective analysis of 64 consecutive patients with suspected recurrent HNSCC following definitive treatment who underwent PET-CT imaging were eligible for inclusion. Patients with previous known distant metastatic disease were excluded. RESULTS: The majority of patients (81%) had TNM stage III or IV disease. PET-CT was suspicious for pulmonary malignancy in 14 patients (22%) and indeterminate in 6 patients (9%). Pulmonary metastases or a new lung primary were present in 10 patients (16%): 7 of 14 patients with positive PET-CT scans (50%) and 3 of 50 patients with negative or indeterminate PET-CT scans (6%). Including nonpulmonary sites, the overall incidence of distant disease was 23% (15/64) with 20% (13/64) unsuspected prior to PET-CT. The sensitivity and specificity of PET-CT in predicting distant malignancy was 86% and 84%, respectively, with a positive predictive value of 60% and a negative predictive value of 95%. There was a significant correlation between standardized uptake value (SUV) on PET-CT and positive histology, with a mean SUV of 8.5 (range, 4.7-16.2) in patients with distant metastases compared with a mean SUV of 2.9 (range, 1.9-4.2) in patients with benign pathology (r = 0.87, P < .0001). CONCLUSIONS: A significant number of patients with recurrent HNSCC have distant metastases at the time of recurrence. These data suggest that PET-CT improves detection of metastatic disease in the high-risk patient and should be performed as part of the routine evaluation of patients with suspected recurrence prior to salvage surgery. |
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Authors:
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Christine G Gourin; Tammara Watts; Hadyn T Williams; Vijay S Patel; Paul A Bilodeau; Teresa A Coleman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Laryngoscope Volume: 119 ISSN: 1531-4995 ISO Abbreviation: Laryngoscope Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-31 Completed Date: 2009-04-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: United States |
Other Details:
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Languages: eng Pagination: 703-6 Citation Subset: IM |
Affiliation:
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Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland 21287, USA. cgourin1@jhmi.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Carcinoma, Squamous Cell / epidemiology, radiography, radionuclide imaging*, secondary*, surgery Chemotherapy, Adjuvant Female Head and Neck Neoplasms / pathology, surgery Humans Incidence Lung Neoplasms / epidemiology, radiography, radionuclide imaging*, secondary* Male Middle Aged Neoplasm Recurrence, Local / radiography, radionuclide imaging Positron-Emission Tomography Preoperative Care Radiotherapy, Adjuvant Retrospective Studies Salvage Therapy Sensitivity and Specificity Tomography, X-Ray Computed |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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