Objective: To evaluate the contribution of 18FDG positron emission tomography for the post treatment surveillance of head and neck carcinomas.
Methods: : This prospective study included 61 patients with advanced squamous cell carcinoma of the upper airways and/or digestive tract and who underwent curative treatment. Patients underwent a standard workup (physical examination, CT scan and panendoscopy) and a PET/CT image fusion 3 months after the end of treatment. The follow-up was 6 months minimum in all patients after this workup. PET/CT was evaluated in terms of: primary tumor, cervical lymph nodes, metastases and overall patient assessment.
Results: : For diagnosis of the primary tumor, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT were respectively 86.7%, 82.6%, 62%, 95% and 83.6%. Values for cervical lymph nodes were: 100%, 98.2%, 80%, 100% and 98.3%. Values for metastases were: 100%, 92.2%, 66.7%, 100% and 93.2%. Values for overall patient assessment were: 88.8%, 78.1%, 64%, 94.1% and 81.4%. Performances of PET/CT were better than standard workup in 22% of patients.
Conclusion: PET/CT contributes useful information in this indication, particularly an excellent negative predictive value.