title: Should We Routinely Investigate Incidental Head and Neck Findings on 18-Fluorodeoxyglucose Positron Emission Tomography in Patients Being Staged for Non-small Cell Lung Cancer? A Retrospective Analysis.
abstract: BACKGROUND
  Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) is routinely performed for investigating suspected lung cancers. Despite the known potential for false-positive FDG uptake in the head and neck, most suspicious lesions on FDG-PET are investigated.
  
  
  METHODS
  Between October 2002 and January 2010, FDG-PET/PET-computed tomography (CT) reports showing significant incidental uptake were retrospectively analyzed using controls to compare time to treatment for lung cancer and the rate of secondary malignancy in those with and without incidental head and neck FDG uptake.
  
  
  RESULTS
  In this study, 48/1,846 PET/PET-CT scan reports reviewed, and demonstrated nonthyroidal head and neck abnormalities. A total of 30 patients had proven non-small cell lung cancer (1.6%); 3/30 (10%) went on to have biopsy proven malignancy. Furthermore, there was a significant increase in time to treatment in those patients with incidental head and neck findings (p = 0.002).
  
  
  CONCLUSIONS
  These unexpected findings are mostly of no clinical significance and the patient should continue treatment without delay; however, aggressive work-up should be pursued if concerns for head and neck pathology are raised following clinical assessment.
authors: Division of Thoracic Surgery, St George's Hospital, London, England, United Kingdom.
authors: Akshay
authors: A
authors: Patel
authors: Department of Thoracic Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors: Troy
authors: T
authors: Perry
authors: Division of Thoracic Surgery, St George's Hospital, London, England, United Kingdom.
authors: Ian
authors: I
authors: Hunt
authors: Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
authors: Jonathan
authors: J
authors: Abele
authors: Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
authors: Connor
authors: C
authors: Maquire
authors: Division of Otolaryngology, University of Alberta, Edmonton, Alberta, Canada.
authors: Michael
authors: M
authors: Allegretto
authors: Department of Thoracic Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors: Eric
authors: E
authors: Bedard
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000494:pharmacology*; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D033162:Incidental Findings; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D016609:Neoplasms, Second Primary / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals / Q000494:pharmacology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18