[Value of positron emission tomography with 18-fluorodeoxyglucose (FDG-PET) in early detection of residual tumor in oro-pharyngeal-laryngeal carcinoma].
OBJECTIVE
To evaluate and compare the performances of FDG-PET imaging, MRI and clinical examination in the detection of residual tumour 3 months after treatment of patients with head and neck squamous cell carcinoma.


METHODS
A consecutive sample of 50 patients with squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx or larynx, or a cervical lymph node metastasis from an unknown primary site excluding T1 lip and T1 vocal cord tumours.


METHODS
Treatment outcome was assessed after 3 months by clinical examination, MRI, and FDG-PET scan. Sensitivity, specificity and accuracy were calculated relative to proven biopsy of residual tumour or a clinical follow-up of 4 months.


RESULTS
Residual cancer was confirmed in 8 patients (16%), while the clinical follow-up was unsuspicious in the remaining 42 patients. PET-FDG had a sensitivity of 100% as compared to MRI (88%) and clinical examination (63%). Specificity was higher for clinical examination (90%), intermediate for MRI (83%) and lowest for PET-FDG (74%).


CONCLUSIONS
This study finds very high sensitivity for PET-FDG in the detection of residual tumour. However, its lower specificity, lack of anatomical resolution, and high cost, require further studies to determine its role in routine screening.
Haenggeli
C A
CA
Clinique et policlinique d'otorhinolaryngologie et de chirurgie cervico-faciale, Hôpitaux Universitaires de Genève.
Dulguerov
P
P
Slosman
D
D
Becker
M
M
Bang
P
P
Allal
A
A
Guyot
J P
JP
Lehmann
W
W
D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D011237:Predictive Value of Tests; D014055:Tomography, Emission-Computed
D003287:Contrast Media; D019788:Fluorodeoxyglucose F18