Recurrence of head and neck cancer after surgery or irradiation: prospective comparison of 2-deoxy-2-[F-18]fluoro-D-glucose PET and MR imaging diagnoses.
OBJECTIVE
To evaluate the diagnostic accuracy of positron emission tomography (PET) with administration of 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) relative to that of magnetic resonance (MR) imaging and/or computed tomography (CT) in recurrent head and neck cancers.


METHODS
Twelve adult patients (mean age, 63 years) with previously treated head and neck cancers and clinical suspicion of recurrence underwent FDG PET and MR imaging and/or CT. All images were blindly and independently interpreted without histopathologic findings (obtained within 1 week of imaging). The level of confidence in image interpretation was graded by using a five-point rating system (0 = definitely no recurrence to 4 = definite recurrence).


RESULTS
Recurrence was confirmed in eight patients. With a rating of 4 as a positive finding, FDG PET yielded a sensitivity and specificity of 88% (seven of eight) and 100% (four of four), respectively; MR imaging and/or CT, 25% (two of eight) and 75% (three of four), respectively. Receiver-operating characteristic analysis showed significantly better diagnostic accuracy with FDG PET than with MR imaging and/or CT (area under curve = 0.96 vs 0.55, P < .03).


CONCLUSIONS
These data indicate that PET metabolic imaging, as compared with anatomic methods, has improved diagnostic accuracy for recurrent head and neck cancer.
Anzai
Y
Y
Department of Radiology, University of Michigan Medical Center, University Hospital, Ann Arbor 48109-0028, USA.
Carroll
W R
WR
Quint
D J
DJ
Bradford
C R
CR
Minoshima
S
S
Wolf
G T
GT
Wahl
R L
RL
D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose