title: Comparison of PET/CT with conventional imaging modalities (USG, CECT) in evaluation of N0 neck in head and neck squamous cell carcinoma.
abstract: BACKGROUND
  Evaluation of a clinically N0 neck is mandatory in cases of squamous cell carcinoma of head and neck region in order to determine the need to address the neck. The study was designed to compare the accuracy of PET/CT scan with that of USG and CECT Neck in assessing clinically N0 neck in cases of squamous cell carcinoma of upper aerodigestive tract.
  
  
  METHODS
  Single center, prospective, study over a 2 year period. All Cases of squamous cell carcinoma of upper aerodigestive tract with no palpable neck lymphadenopathy and who were scheduled for surgery were evaluated with USG, CECT and 18F-FDG PET/CT, of the neck. Post operative histopathology was correlated with pre-operative nodal status. Statistical analysis was done using the chi square test.
  
  
  RESULTS
  In the 49 patients enrolled, 51 neck sides underwent dissections. Sensitivity of USG, CECT and PET-CT was 4.76%, 23.80% and 71.43% respectively while the specificity was 93.33%, 93.33% and 96.67% respectively. The positive predictive value (PPV) calculated for USG, CECT and PET-CT was 33.33%, 71%, 93.5% respectively while the negative predictive value (NPV) 58.33%, 63.63% and 82.85% respectively.
  
  
  CONCLUSIONS
  In N0 neck in head and neck squamous cell carcinoma, though FDG-PET-CT is more accurate than either USG or CECT in staging of the neck, it is not accurate enough to alter the current treatment paradigm.
authors.affiliation: Classified Specialist (Surgery & Oncosurgeon), Command Hospital (CC), Lucknow, India.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Chauhan
authors.affiliation: Resident, Oncology Center, AH (R&R), New Delhi, India.
authors.forename: Pranjal
authors.initials: P
authors.lastname: Kulshrestha
authors.affiliation: Consultant (Surgery & Oncosurgery), Command Hospital (CC), Lucknow, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kapoor
authors.affiliation: Senior Advisor (Nuclear Medicine), Command Hospital (SC), Pune 411040, India.
authors.forename: Harkirat
authors.initials: H
authors.lastname: Singh
authors.affiliation: Senior Advisor (Nuclear Medicine), INHS Asvini, Colaba, Mumbai, India.
authors.forename: M J
authors.initials: MJ
authors.lastname: Jacob
authors.affiliation: Classified Specialist (Radiodiagnosis), INHS Dhanvantari, Port Blair, India.
authors.forename: Maneel
authors.initials: M
authors.lastname: Patel
authors.affiliation: Commandant, Military Hospital, Roorkee, India.
authors.forename: Manomoy
authors.initials: M
authors.lastname: Ganguly
keywords: CECT; N0 neck staging; PET/CT; Ultrasound