Document Detail


Identification of distant metastases with PET-CT in patients with suspected recurrent head and neck cancer.
MedLine Citation:
PMID:  19205017     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Christine G Gourin; Tammara Watts; Hadyn T Williams; Vijay S Patel; Paul A Bilodeau; Teresa A Coleman
Related Documents :
6863667 - Clinical value of ultrasonography for the management of non-hodgkin lymphoma patients a...
19917927 - Neck response to chemoradiotherapy: complete radiographic response correlates with path...
17515747 - Impact of pet/ct in comparison with same day contrast enhanced ct in breast cancer mana...
12865867 - Advanced ovarian carcinoma: usefulness of [(18)f]fdg-pet in combination with ct for les...
7942997 - Is fragile x syndrome a pervasive developmental disability? cognitive ability and adapt...
19095817 - Interobserver variability in the measurement of abdominal aortic calcification using un...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  119     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-31     Completed Date:  2009-04-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  703-6     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland 21287, USA. cgourin1@jhmi.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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


Previous Document:  Disturbance of vestibular function attributable to cochlear implantation in children.
Next Document:  Coincidence of conchachoanal polyp and complete mulberry hypertrophy of inferior concha.