Document Detail


Identification of distant metastases with positron-emission tomography-computed tomography in patients with previously untreated head and neck cancer.
MedLine Citation:
PMID:  18197136     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 previously untreated head and neck squamous cell cancer (HNSCC) prior to definitive treatment. MATERIALS AND METHODS: Retrospective analysis of 27 consecutive patients with previously untreated HNSCC who underwent PET-CT imaging in addition to chest radiography (CXR) as part of their metastatic workup. RESULTS: The majority of patients (89%) had TNM stage III or IV disease. PET-CT was suspicious for pulmonary malignancy in four (15%) patients and indeterminate in one (4%) patient. CXR was suspicious for pulmonary malignancy in two (7%) patients. Pulmonary metastases or a new lung primary was present in 3 (11%) patients: 3 of 4 (75%) patients with positive PET-CT scans and 0 of 23 (0%) patients with negative or indeterminate PET-CT scans compared with 2 of 2 (100%) patients with positive CXR and 1 of 25 (4%) patients with negative CXR. The sensitivity and specificity of PET-CT in predicting pulmonary malignancy was 100% and 96%, respectively, with a positive predictive value of 75% and a negative predictive value of 100%. The sensitivity and specificity of CXR in predicting pulmonary malignancy was 67% and 100%, respectively, with a positive predictive value of 100% and a negative predictive value of 96%. Including nonpulmonary sites, the overall incidence of distant metastatic disease was 19% (5/27) with 11% (3/27) unsuspected prior to PET-CT. CONCLUSIONS: PET-CT improves detection of metastatic disease in the high-risk patient and should be performed as part of the routine pretreatment evaluation of patients with advanced stage HNSCC.
Authors:
Christine G Gourin; Tammara L Watts; Hadyn T Williams; Vijay S Patel; Paul A Bilodeau; Teresa A Coleman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  118     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-31     Completed Date:  2008-06-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  671-5     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, Georgia, USA. cgourin1@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Carcinoma, Squamous Cell / diagnosis,  secondary*
Contrast Media
Female
Fluorodeoxyglucose F18 / diagnostic use
Follow-Up Studies
Head and Neck Neoplasms / pathology*
Humans
Laryngeal Neoplasms / pathology
Lung Neoplasms / diagnosis,  secondary*
Male
Middle Aged
Mouth Neoplasms / pathology
Neoplasm Staging
Oropharyngeal Neoplasms / pathology
Positron-Emission Tomography / methods*
Predictive Value of Tests
Radiography, Thoracic
Radiopharmaceuticals / diagnostic use
Retrospective Studies
Sensitivity and Specificity
Tomography, Spiral Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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


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