Systematic review: accuracy of imaging tests in the diagnosis of recurrent laryngeal carcinoma after radiotherapy.
BACKGROUND
Diagnosing recurrent laryngeal tumor after radiotherapy is challenging. The most reliable method is direct laryngoscopy under general anesthesia. However, many futile laryngoscopies are performed in disease-free patients. Imaging tests selecting patients for this invasive procedure would be useful. The aim of this systematic review was summarizing the available evidence and determining the diagnostic accuracy of CT, MRI, thallium-201 (201Tl) scintigraphy, and F-18-fluorodeoxyglucose positron emission tomography (18FDG-PET).


METHODS
A systematic review was performed according to the guidelines of the Cochrane Collaboration. Two reviewers scored the articles according to A-, B-, and C-items. Statistical meta-analysis was performed producing summary pooled estimates of sensitivity and specificity.


RESULTS
There were 8 eligible studies on 18FDG-PET. The validity of the 18FDG-PET studies was reasonable; the pooled estimates (95% CI) for sensitivity and specificity were 89% and 74%.


CONCLUSIONS
The diagnostic accuracy of 18FDG-PET is promising and warrants a randomized trial comparing a strategy based on conventional diagnostic work-up to one based on 18FDG-PET.
Brouwer
Jolijn
J
Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Hooft
Lotty
L
Hoekstra
Otto S
OS
Riphagen
Ingrid I
II
Castelijns
Jonas A
JA
de Bree
Remco
R
Leemans
C René
CR
D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy; D016001:Confidence Intervals; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007822:Laryngeal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000532:radiotherapy*; D015588:Observer Variation; D049268:Positron-Emission Tomography / Q000379:methods; D011336:Probability; D012372:ROC Curve; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
D019788:Fluorodeoxyglucose F18