J Nucl Med. 2007; 48 (Supplement 2):35P
Oncology: Clinical Diagnosis-Solid Tumors
Head and Neck II: Evaluation of the Extent of Disease |
Utility of FDG-PET in surveillance for recurrent head and neck cancer
Tony Abraham1,
Jonathan Engbers1,
Rajkumar Yarlagadda1 and
Michael Graham1
1 Nuclear Medicine, University of Iowa Hospital and Clinics, Iowa City, Iowa
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Objectives: [18F]Fluorodeoxyglucose positron emission tomography (FDG-PET) is beginning to be used as a primary surveillance tool following definitive treatment of head and neck (H&N) cancer. The goal of this study was to further elucidate the accuracy of FDG-PET in detecting recurrence of the most common types of H&N cancer. Methods: We performed a retrospective review of 616 patients who underwent 872 PET scans from September, 2001 to January, 2006 for post treatment surveillance. All patients with no known recurrence at the time of PET and with at least one year of clinical follow-up after PET were included in the study. We only examined results for the first PET study after end of treatment. This left 202 patients who where included in subsequent analysis. PET studies were assigned a score of 1-4 – negative (1), probably negative (2), probably positive (3), or positive (4). Clinical follow-up, late recurrence and metastasis, and incidental finding of other cancers were also assigned a score of 1-4 - no disease (1), probably negative (2), probably positive (3), or positive biopsy (4). Scores of 3 and 4 were counted as positive for purposes of data analysis. Results: Of the 202 pts studied, 144 were found to have no disease recurrence by PET and clinical criteria, while the remaining 58 did have evidence of disease recurrence. The table below lists the various regional subsets investigated, sensitivity, specificity, PPV, NPV and accuracy. Conclusions: Because of the high NPV, FDG-PET is a very effective tool for surveillance of H&N cancer patients for recurrence. The low PPV suggests that positive findings need to be confirmed by biopsy.
