title: The role of positron emission tomography and computed tomography fusion in the management of early-stage and advanced-stage primary head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  To evaluate the role of positron emission tomography and computed tomography (PET-CT) fusion in the management of early-stage and advanced-stage primary head and neck squamous cell cancer.
  
  
  METHODS
  Retrospective analysis, with a blinded evaluation of clinical data and formation of a treatment plan.
  
  
  METHODS
  Single tertiary academic medical institution. Patients Thirty-six patients with previously untreated head and neck squamous cell carcinoma who underwent staging CT or magnetic resonance imaging of the neck prior to undergoing PET-CT as part of their initial diagnostic evaluation between July 2000 and January 2005.
  
  
  METHODS
  Confirmation or alteration of the treatment plan with the addition of the PET-CT information compared with traditional clinical and radiological data alone for early-stage and advanced-stage disease. When available, histopathological results were correlated with the PET-CT findings.
  
  
  RESULTS
  Among the 36 patients, PET-CT provided additional information that confirmed the treatment plan in 25 patients (69%) and altered the treatment plan in 11 patients (31%). Six of 11 patients in the altered-treatment group had their tumors upstaged. Four of 8 patients with early-stage tumors had their treatment plan altered, compared with 7 of 28 patients with advanced-stage disease. Among 18 patients who underwent a surgical intervention for their primary tumor, PET-CT identified the primary tumor in all 18 patients and, based on histopathological findings, correctly staged the regional nodal disease in 9 of 16 patients who had their nodal disease addressed.
  
  
  CONCLUSIONS
  The use of PET-CT is important in the initial treatment planning of early-stage and advanced-stage head and neck squamous cell carcinoma.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery and Nuclear Medicine, The Johns Hopkins University School of Medicine, 601 N. Caroline Street, Baltimore, MD 21287-0910, USA.
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Ha
authors.forename: Alia
authors.initials: A
authors.lastname: Hdeib
authors.forename: David
authors.initials: D
authors.lastname: Goldenberg
authors.forename: Heather
authors.initials: H
authors.lastname: Jacene
authors.forename: Pavni
authors.initials: P
authors.lastname: Patel
authors.forename: Wayne
authors.initials: W
authors.lastname: Koch
authors.forename: Joseph
authors.initials: J
authors.lastname: Califano
authors.forename: Charles W
authors.initials: CW
authors.lastname: Cummings
authors.forename: Paul W
authors.initials: PW
authors.lastname: Flint
authors.forename: Richard
authors.initials: R
authors.lastname: Wahl
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Tufano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed