[Role of [18]-FDG PET/CT in the initial staging of head and neck cancers].
OBJECTIVE
To evaluate the impact of fusion of positron emission tomography with computed tomography (FDG-PET/CT) in the initial staging of head and neck carcinomas.


METHODS
This retrospective study included 44 patients with squamous cell carcinoma of the upper aerodigestive tract. Patients underwent a standard workup and a PET/CT image fusion during the initial staging. The standard workup included CT scan of the head, neck and chest, panendoscopy under general anaesthesia, oesophageal endoscopy and abdominal echography. Potential additional diagnostic value of PET/CT was evaluated.


RESULTS
Findings between PET/CT and standard workup were concordant in 41/44 cases for primary tumour in 79/88 cases for lymph node staging, in 36/44 cases for distant metastases (or distant second primary) and in 41/44 cases for synchronous second primaries of the upper aero-digestive tract. PET/CT leads to a change of treatment for 6.8% of patients (1 for lymph node staging and 2 for distant metastases). 17.2% of pathological FDG uptake foci found by PET/CT were false-positives results.


CONCLUSIONS
PET/CT enables to realise a whole body check-up in a single time. However, it cannot be used alone, due to its lack of spatial resolution: It must be used in complement of the standard workup. This high rate of false-positive findings, asking for further expensive diagnostic procedures, limits its usefulness.
Fakhry
N
N
CHU La Timone, Hôpital Timone adultes, Service d'ORL et de Chirurgie Cervico-Faciale du Pr Zanaret, 264, rue Saint Pierre, 13385 Marseille cedex 05, France. nfakhry@yahoo.fr
Barberet
M
M
Lussato
D
D
Mundler
O
O
Giovanni
A
A
Zanaret
M
M
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18