Positron emission tomography-computed tomography surveillance for the node-positive neck after chemoradiotherapy.
OBJECTIVE
To review our results with positron emission tomography and computed tomography fusion imaging (PET-CT) surveillance of the postchemoradiotherapy neck in patients with advanced head and neck squamous cell carcinoma.


METHODS
Retrospective.


METHODS
Four hundred twenty-eight patients with advanced head and neck squamous cell carcinoma were treated with nonsurgical therapy from September 2002 to March 2007 and followed with post-treatment PET-CT surveillance of the neck. Fifty-two patients meeting inclusion criteria were analyzed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET-CT were determined.


RESULTS
Ten patients had a positive post-treatment PET-CT for residual neck disease, and 42 patients had negative scans. The NPV and PPV were 100% and 40%, respectively. The sensitivity, specificity, and accuracy were 100%, 87.5%, and 88%, respectively.


CONCLUSIONS
Planned neck dissection can be deferred with a negative post-treatment PET-CT. Assuming a complete response at the primary site and a negative PET-CT scan, there may be a role for serial PET-CT surveillance in patients with residual palpable cervical lymphadenopathy. Laryngoscope, 2009.
Department of Otolaryngology and Head Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA.
Amy G
AG
Rabalais
Rohan
R
Walvekar
Daniel
D
Nuss
Andrew
A
McWhorter
Charles
C
Wood
Robert
R
Fields
Donald E
DE
Mercante
Anna M
AM
Pou
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging*; D010039:Otorhinolaryngologic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D049268:Positron-Emission Tomography; D020266:Radiotherapy, Conformal; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18