Interpretability of PET/CT imaging in head and neck cancer patients following composite mandibular resection and osteocutaneous free flap reconstruction.
BACKGROUND
We investigated positron emission tomography (PET)/CT scanning following segmental resections and osteocutaneous free-flap reconstruction. The interpretability of PET/CT imaging with healing osteotomies and reconstruction hardware was analyzed.


METHODS
Patient scans within 18 months of surgery were interpreted for malignancy. Interpretations were compared with clinical data to determine sensitivity/specificity. Standardized uptake values (SUVs) were determined for bony controls, osteotomies, and tumors and were analyzed using paired t test.


RESULTS
Fifteen scans were visually interpreted, 13 underwent SUV analysis. Reconstruction hardware did not interfere with interpretability. Sensitivity and specificity were 88% and 86%, respectively. Osteotomy sites averaged 25% higher SUVs compared with bony controls (vs sternum p = .003, vs mandible p = .008). Tumor SUVs were higher than osteotomies (p = .023) and controls (vs sternum p = .013, vs mandible p = .025).


CONCLUSIONS
Although osteotomies were characterized by an increased fluorodeoxyglucose signal, scan interpretability was unimpaired. Our study suggests that PET/CT imaging can be utilized to survey free-flap patients at acceptable levels of sensitivity/specificity.
Oliver
Christopher
C
Department of Otolaryngology, University of Pittsburgh Eye and Ear Institute, 200 Lothrop St., Suite 500, Pittsburgh, Pennsylvania 15213-2546, USA. olivercl@upmc.edu
Muthukrishnan
Ashok
A
Mountz
James
J
Deeb
Erin
E
Johnson
Jonas
J
Deleyiannis
Frederic
F
D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy; D049268:Positron-Emission Tomography / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed