title: (18)F-FDG-PET/CT versus panendoscopy for the detection of synchronous second primary tumors in patients with head and neck squamous cell carcinoma.
abstract: BACKGROUND
  This study assesses the additional value of (18)F-fluoro-2-deoxy-D-glucose positron emission tomography/CT ((18)F-FDG-PET/CT) with respect to synchronous primaries in patients undergoing panendoscopy for staging of head and neck squamous cell carcinoma.
  
  
  METHODS
  In all, 311 patients underwent both modalities. Cytology, histology, and/or clinical/imaging follow-up served as reference standard.
  
  
  RESULTS
  The prevalence of second primary tumors detected by panendoscopy was 4.5%, compared with 6.1% detected by (18)F-FDG-PET/CT. The sensitivity for panendoscopy was 74%, the specificity was 99.7%, the positive predictive value (PPV) was 93%, and the negative predictive value (NPV) was 98%. The sensitivity for (18)F-FDG-PET/CT was 100%, the specificity was 95.7%, the PPV was 59%, and the NPV was 100%.
  
  
  CONCLUSIONS
  (18)F-FDG-PET/CT is superior to panendoscopy. With a negative (18)F-FDG-PET/CT, the extent of endoscopy can be reduced to the area of the primary tumor. Due to the costs, (18)F-FDG-PET/CT is recommended only in advanced disease to assess potential distant disease. In early-stage cancer, panendoscopy is accurate enough to rule out secondary tumors.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland. Stephan.haerle@usz.ch
authors.forename: Stephan K
authors.initials: SK
authors.lastname: Haerle
authors.forename: Klaus
authors.initials: K
authors.lastname: Strobel
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Hany
authors.forename: Daniel
authors.initials: D
authors.lastname: Sidler
authors.forename: Sandro J
authors.initials: SJ
authors.lastname: Stoeckli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy; D015331:Cohort Studies; D004724:Endoscopy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000628:therapy; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18