title: Negative predictive value of surveillance PET/CT in head and neck squamous cell cancer.
abstract: OBJECTIVE
  Optimizing the utilization of surveillance PET/CT in treated HNSCC is an area of ongoing research. Our aim was to determine the negative predictive value of PET/CT in patients with treated head and neck squamous cell cancer and to determine whether negative PET/CT reduces the need for further imaging surveillance.
  
  
  METHODS
  We evaluated patients with treated HNSCC who underwent posttreatment surveillance PET/CT. During routine clinical readouts, scans were categorized as having negative, probably negative, probably malignant, or malignant findings. We followed patients clinically and radiographically for at least 12 months from their last PET/CT (mean, 26 months; median, 28 months; range, 12-89 months) to determine recurrence rates. All suspected recurrences underwent biopsy for confirmation.
  
  
  RESULTS
  Five hundred twelve patients (1553 scans) were included in the study. Two hundred fourteen patients had at least 1 PET/CT with negative findings. Of the 214 patients with a scan with negative findings, 19 (9%) eventually experienced recurrence, resulting in a NPV of 91%. In addition, a subgroup of 114 patients with 2 consecutive PET/CT examinations with negative findings within a 6-month period was identified. Only 2 recurrences were found in this group, giving a NPV of 98%.
  
  
  CONCLUSIONS
  In patients treated for HNSCC, a single PET/CT with negative findings carries a NPV of 91%, which is not adequate to defer further radiologic surveillance. Two consecutive PET/CT examinations with negative findings within a 6-month period, however, resulted in a NPV of 98%, which could obviate further radiologic imaging in the absence of clinical signs of recurrence.
authors: Department of Radiology, New York University, New York, NY, USA.
authors: M
authors: M
authors: McDermott
authors: M
authors: M
authors: Hughes
authors: T
authors: T
authors: Rath
authors: J T
authors: JT
authors: Johnson
authors: D E
authors: DE
authors: Heron
authors: G J
authors: GJ
authors: Kubicek
authors: S W
authors: SW
authors: Kim
authors: R L
authors: RL
authors: Ferris
authors: U
authors: U
authors: Duvvuri
authors: J P
authors: JP
authors: Ohr
authors: B F
authors: BF
authors: Branstetter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D010414:Pennsylvania / Q000453:epidemiology; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D018571:Sentinel Surveillance; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D016896:Treatment Outcome
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