What does PET imaging add to conventional staging of head and neck cancer patients?
OBJECTIVE
To determine the value of PET scans in the staging of patients with head and neck carcinoma.


METHODS
The charts of 25 patients who underwent neck dissection, computed tomography (CT) scan, and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging as part of their initial work-up for a head and neck squamous cell cancer between 2000-2003 were reviewed. All patients underwent clinical examination, triple endoscopy, and chest radiograph as part of their clinical staging, adhering to American Joint Commission for Cancer criteria. In addition to the clinical nodal (N) stage, PET findings were incorporated to determine a second type of N staging: clinical N + PET stage. The number of neck sides and nodal levels involved on CT or PET and on pathologic examination were recorded.


RESULTS
The sensitivity and specificity for detection of nodal disease were similar for CT and FDG-PET. Positive and negative likelihood ratios were similar for both diagnostic tests. None of our 25 patients had unsuspected distant disease detected by PET.


CONCLUSIONS
The addition of PET imaging did not improve diagnostic accuracy in our patients compared with CT. PET scanning did not alter clinical management in any of the patients.
Pohar
Surjeet
S
Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA. poharss@evms.edu
Brown
Robert
R
Newman
Nancy
N
Koniarczyk
Michael
M
Hsu
Jack
J
Feiglin
David
D
D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008297:Male; D037981:Neck Dissection; D009367:Neoplasm Staging / Q000379:methods / Q000592:standards*; D049268:Positron-Emission Tomography / Q000379:methods / Q000592:standards*; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18