title: Improvement in the detection of locoregional recurrence in head and neck malignancies: F-18 fluorodeoxyglucose-positron emission tomography/computed tomography compared to high-resolution contrast-enhanced computed tomography and endoscopic examination.
abstract: OBJECTIVE
  To compare the diagnostic efficacy of positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG-PET)/computed tomography (CT) to that of contrast-enhanced high-resolution CT (HRCT) and assess the value of a combinatorial approach in detection of recurrent squamous cell cancer of the head and neck (HNC) and to assess the efficacy of FDG-PET/CT with and without HRCT in comparison to standard-of-care follow-up--physical examination (PE) and endoscopy (E)--in determination of locally recurrent HNC.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  A total of 103 patients with HNC underwent FDG-PET/CT and neck HRCT. There were two groups of patients: Group A had an FDG-PET study acquired with low-dose CT, and group B had an FDG-PET study acquired with HRCT. The PET data obtained with or without HRCT were compared on a lesion and patient basis with the results of the PE/E.
  
  
  RESULTS
  On a lesion basis, both groups combined had higher sensitivity and negative predictive value (NPV) than the HRCT. Specificity and positive predictive value (PPV) for group B were higher than for group A. On a patient basis, both groups combined had a higher sensitivity and NPV than PE/E, respectively, although specificity of PE/E was higher than that of either group. PET data obtained with either protocol directly influenced treatment.
  
  
  CONCLUSIONS
  HRCT increases the specificity and PPV of PET/CT when acquired simultaneously with PET. FDG-PET/CT acquired with either LDCT or HRCT has higher accuracy than HRCT alone and increases the sensitivity and NPV of PE/E.
authors.affiliation: Department of Radiology, Mount Sinai Medical Center, New York, New York, U.S.A.
authors.forename: Balasubramanya
authors.initials: B
authors.lastname: Rangaswamy
authors.forename: M Reza
authors.initials: MR
authors.lastname: Fardanesh
authors.forename: Eric M
authors.initials: EM
authors.lastname: Genden
authors.forename: Eunice E
authors.initials: EE
authors.lastname: Park
authors.forename: Girish
authors.initials: G
authors.lastname: Fatterpekar
authors.forename: Zara
authors.initials: Z
authors.lastname: Patel
authors.forename: Jongho
authors.initials: J
authors.lastname: Kim
authors.forename: Peter M
authors.initials: PM
authors.lastname: Som
authors.forename: Lale
authors.initials: L
authors.lastname: Kostakoglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004724:Endoscopy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D010808:Physical Examination; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: F-18 fluorodeoxyglucose positron emission tomography; computed tomography; neck high-resolution computed tomography; recurrent squamous cell cancer of the head and neck