J Nucl Med. 2007; 48 (Supplement 2):36P
Oncology: Clinical Diagnosis-Solid Tumors
Head and Neck II: Evaluation of the Extent of Disease |
Does FDG PET improve recurrence detection of head and neck squamous cell carcinoma in patients with a negative clinical follow-up?
Ronan Abgral2,
Francoise Kraeber-Bodere1,
Solene Querellou2,
Pierre Cambefort2,
Gerald Valette3,
Olivier Pradier4,
Remi Marianovski3,
Yves Bizais2 and
Pierre Salaun1
1 Nuclear Medicine, Gauducheau Cancer Center Nantes, Nantes, France; ;
2 Nuclear Medicine; ;
3 Head and Neck Surgery; ;
4 Oncology and Radiotherapy, University Hospital, Brest, France
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Objectives: Posttreatment surveillance of head and neck squamous cell carcinoma (HNSCC) recurrence is a diagnostic challenge. Tissue distortions from radiation and surgery can obscure early detection of recurrence by conventional follow-up approaches such as physical examination (PE), computed tomography, and magnetic resonance imaging. A number of studies have shown that 18Fluoro-fluorodeoxyglucose (18FDG) positron emission tomography (PET) may be an effective technique for the detection of persistent, recurrent, and distant metastatic HNSCC after treatment. The aim of this study was to assess the benefits of 18F-FDG PET in the detection of HNSCC subclinical locoregional recurrence and distant metastasis in patients cured of HNSCC with negative conventional follow up and to assess the diagnostic accuracy of 18F-FDG PET in theses patients. Methods: Fifty two patients cured of head and neck squamous cell carcinoma (HNSCC) without any clinical element for recurrence were evaluated. Whole-body 18FDG-PET examination was performed 18 ± 12 months after the end of the treatment. The gold standard was histopathology or follow-up. Results: The whole-body 18F-FDG PET of the 52 patients in this study consisted of 34 negative and 18 positive results. 3 of these patients who exhibited abnormal 18F-FDG uptake in laryngeal area did not have recurrent HNSCC (false positive). 15 had proven recurrence. The sensitivity and specificity of 18F-FDG PET in this study for the diagnosis of HNSCC recurrence were 100% (15/15) and 92% (34/37). The positive predictive value was 83% (15/18). The negative predictive value was 100% (34/34). The overall accuracy was 94% (49/52). Conclusions: The results of our study confirm the effectiveness of 18F-FDG PET in assessment of HNSCC recurrence in particular for distant metastasis and suggest that it is more accurate than conventional follow-up PE alone in the assessment of patient recurrence after previous curative treatment for HNSCC.
