Impact of FDG-PET to detect recurrence of head and neck squamous cell carcinoma.
OBJECTIVE
Prospectively evaluate the impact of fluorodeoxyglucose-fluorine-18 positron emission tomography (FDG-PET) in the management of recurrence of advanced head and neck squamous cell carcinoma during the first year after treatment.


METHODS
Seventy patients were followed-up every 6 to 8 weeks during the first year after initial combined curative therapy. FDG-PET, together with conventional imaging and endoscopy were performed systematically at 1 year (group A) or prompted earlier in case of clinically suspicious recurrence (group B). The referring physician evaluated the impact of FDG-PET on the patient's management. Another clinician checked the pertinence of decisions.


RESULTS
FDG-PET had a therapeutic impact in 8 of 43 group A patients and in 16 of 27 group B patients; the overall rate was 34%. This change was pertinent in 5 of 8 and 14 of 16 cases, respectively. Overall pertinence rate of decisions was 90% versus 70% without FDG-PET.


CONCLUSIONS
FDG-PET had a significant overall therapeutic impact; the induced decisions were either pertinent or just led to "futile" noninvasive examinations. Systematic FDG-PET had a significantly lesser impact in comparison with FDG-PET motivated by clinical suspicion.
Périé
Sophie
S
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine University Pierre et Marie Curie Paris VI and Hospital Tenon AP-HP, Paris, France. sophie.perie@tnn.ap-hop-paris.fr
Hugentobler
Alexis
A
Susini
Bertrand
B
Balogova
Sona
S
Grahek
Dany
D
Kerrou
Khaldoun
K
Montravers
Françoise
F
Chater
Pierre El
PE
St Guily
Jean Lacau
JL
Talbot
Jean-Noël
JN
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary; D003657:Decision Making; D004724:Endoscopy; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18