Positron emission tomography-computed tomography surveillance for the node-positive neck after chemoradiotherapy

Laryngoscope. 2009 Jun;119(6):1120-4. doi: 10.1002/lary.20201.

Abstract

Objectives/hypothesis: To review our results with positron emission tomography and computed tomography fusion imaging (PET-CT) surveillance of the postchemoradiotherapy neck in patients with advanced head and neck squamous cell carcinoma.

Study design: Retrospective.

Methods: Four hundred twenty-eight patients with advanced head and neck squamous cell carcinoma were treated with nonsurgical therapy from September 2002 to March 2007 and followed with post-treatment PET-CT surveillance of the neck. Fifty-two patients meeting inclusion criteria were analyzed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET-CT were determined.

Results: Ten patients had a positive post-treatment PET-CT for residual neck disease, and 42 patients had negative scans. The NPV and PPV were 100% and 40%, respectively. The sensitivity, specificity, and accuracy were 100%, 87.5%, and 88%, respectively.

Conclusions: Planned neck dissection can be deferred with a negative post-treatment PET-CT. Assuming a complete response at the primary site and a negative PET-CT scan, there may be a role for serial PET-CT surveillance in patients with residual palpable cervical lymphadenopathy. Laryngoscope, 2009.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Combined Modality Therapy
  • Disease Progression
  • Female
  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Humans
  • Image Enhancement*
  • Image Processing, Computer-Assisted*
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphatic Metastasis / pathology
  • Lymphatic Metastasis / radiotherapy*
  • Male
  • Middle Aged
  • Neck Dissection
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Neoplasm Staging
  • Neoplasm, Residual / diagnostic imaging*
  • Otorhinolaryngologic Neoplasms / diagnostic imaging
  • Otorhinolaryngologic Neoplasms / drug therapy*
  • Otorhinolaryngologic Neoplasms / pathology
  • Otorhinolaryngologic Neoplasms / radiotherapy*
  • Positron-Emission Tomography*
  • Radiotherapy, Conformal
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*

Substances

  • Fluorodeoxyglucose F18