title: 18F-FDG PET for detecting recurrent head and neck cancer, local lymph node involvement and distant metastases. Comparison of qualitative visual and semiquantitative analysis.
abstract: OBJECTIVE
  Assessment of the clinical value of (18)F-FDG-PET for detection of recurrent head and neck cancer, local lymph node involvement and distant metastases comparing a qualitative visual with a semiquantitative analysis (SUV values).
  
  
  METHODS
  Retrospective evaluation of 73 (18)F-FDG PET studies in 55 patients by use of a four-step qualitative visual grading system and calculation of standard uptake values in pathological lesions. Calculation of SUV values in normal regions for generating a map of physiological (18)F-FDG distribution. Correlation to histopathological findings and clinical follow-up.
  
  
  RESULTS
  1. Qualitative visual analysis of (18)F-FDG PET studies: a) local recurrence sensitivity 79%, specificity 97%, positive predictive value 95%, negative predictive value 85%, and diagnostic accuracy 89%; b) local metastatic lymph nodes 100%, 95%, 85%, 100%, 96%; c) distant metastases 100%, 98%, 86%, 100%, 98%, respectively. 2. Semiquantitative analysis had only little incremental, non-significant value in comparison to qualitative visual analysis for the detection of a local recurrence in two patients: a) local recurrence: sensitivity 83%, specificity 100%, positive predictive value 100%, negative predictive value 88%, and diagnostic accuracy 93%; b) local metastatic lymph nodes or c) distant metastases did not change in comparison to qualitative visual analysis.
  
  
  CONCLUSIONS
  (18)F-FDG PET is an effective tool for re-staging of patients with suspected recurrence after therapy for head and neck cancer.
authors.affiliation: Klinik und Poliklinik für Nuklearmedizin, Klinikum der Universität zu Köln, Joseph-Stelzmann-Str. 9, 50924 Köln, Germany. Matthias.Schmidt@uni-koeln.de
authors.forename: M
authors.initials: M
authors.lastname: Schmidt
authors.forename: M
authors.initials: M
authors.lastname: Schmalenbach
authors.forename: M
authors.initials: M
authors.lastname: Jungehülsing
authors.forename: P
authors.initials: P
authors.lastname: Theissen
authors.forename: M
authors.initials: M
authors.lastname: Dietlein
authors.forename: U
authors.initials: U
authors.lastname: Schröder
authors.forename: W
authors.initials: W
authors.lastname: Eschner
authors.forename: E
authors.initials: E
authors.lastname: Stennert
authors.forename: H
authors.initials: H
authors.lastname: Schicha
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D008297:Male; D009364:Neoplasm Recurrence, Local; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012984:Software; D014018:Tissue Distribution; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18