Document Detail


Role of pretreatment 18FDG-PET/CT in surgical decision-making for head and neck cancers.
MedLine Citation:
PMID:  20054849     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite widespread use, the utility of pretreatment positron emission tomography/computed tomography (PET/CT) remains undefined. In this study, we aim to determine its accuracy in nodal disease.
METHODS: In all, 111 patients managed between 2003 and 2007 were analyzed.
RESULTS: For squamous cell cancers (SCCs) with any increased nodal uptake (mild to high), sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) were 75%, 95%, 85%, and 90%. However, if PET was deemed positive for only moderate to high uptake, sensitivity, specificity, PPV, and NPV were 71%, 95%, 85%, and 89%. In patients undergoing elective neck dissection, the accuracy was lower: for any increased uptake, sensitivity, specificity, PPV, and NPV were 66%, 96%, 83%, and 92%, whereas for moderate to high uptake, these were 52%, 97%, 79%, and 89%.
CONCLUSIONS: Despite advances in PET/CT technology, these statistics suggest that PET/CT is not sufficiently accurate to direct superselective neck dissections, or to guide therapeutic decisions in the N0 neck.
Authors:
N Gopalakrishna Iyer; Jonathan R Clark; Shahlini Singham; Jacqui Zhu
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Head & neck     Volume:  32     ISSN:  1097-0347     ISO Abbreviation:  Head Neck     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8902541     Medline TA:  Head Neck     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1202-8     Citation Subset:  IM    
Affiliation:
Sydney Head and Neck Cancer Institute, Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, Australia. gopaliyer@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Biopsy, Needle
Carcinoma, Squamous Cell / pathology,  radionuclide imaging,  surgery
Cohort Studies
Decision Making
Female
Fluorodeoxyglucose F18 / diagnostic use*
Head and Neck Neoplasms / pathology,  radionuclide imaging*,  surgery*
Humans
Immunohistochemistry
Lymph Node Excision
Lymph Nodes / pathology*
Male
Middle Aged
Neck Dissection / methods
Neoplasm Staging / methods*
Positron-Emission Tomography*
Predictive Value of Tests
Preoperative Care / methods
Retrospective Studies
Sensitivity and Specificity
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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