Use, accuracy, and implications for patient management of [18F]-2-fluorodeoxyglucose-positron emission/computerized tomography for head and neck tumors.
OBJECTIVE
Positron emission tomography (PET) has shown promise for early detection and accurate staging of cancer patients. A limited number of studies suggest PET/computed tomography (CT) may improve these variables; however, no published study has specifically evaluated clinical outcomes with PET/CT for head and neck (HN) tumors. The current study evaluates the use, accuracy, and implications for patient management of PET/CT scans in patients with HN tumors.


METHODS
Retrospective cohort outcomes study at a tertiary care center.


METHODS
The authors identified 795 consecutive PET/CT at our institution. A total of 113 were obtained for HN tumors; 97 were used in the final analysis. Accuracy, use, and implications for patient care management decisions were correlated with each PET/CT scan. Multiple regression analysis was performed.


RESULTS
Accuracy, sensitivity, and specificity were measured by comparing the PET/CT results at the primary tumor site, cervical node sites, and distant sites with either pathologic or definitive clinical diagnoses. PET/CT had an overall per scan accuracy of 72% and a per patient accuracy of 69%. When stratification for rationale of obtaining the scan was performed, accuracy was 80% for staging distant disease, 67% for primary tumor evaluation, 72% for evaluation for recurrence, and 60% for unknown primary tumor evaluation.


CONCLUSIONS
PET/CT imaging is a promising tool for evaluating HN tumors; however, in clinical practice, the proper use of such technology is not well studied. In our study, PET/CT had an overall accuracy of 72% in evaluating HN tumors, and PET/CT had the most accuracy in the detection of distant metastasis.
Zanation
Adam M
AM
Department of Otolaryngology-Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina 27599, USA.
Sutton
David K
DK
Couch
Marion E
ME
Weissler
Mark C
MC
Shockley
William W
WW
Shores
Carol G
CG
D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000378:metabolism; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18