title: The value of (18) F-FDG-PET/CT imaging in oral cavity cancer patients following surgical reconstruction.
abstract: OBJECTIVE
  Follow-up of patients with oral cavity squamous cell carcinoma (OCSCC) after tumor resection and reconstruction with tissue transfer is challenging. We compared contrast-enhanced computed tomography (ceCT), (18) F-fluorodeoxyglucose-positron emission tomography combined with noncontrast enhanced CT ((18) F-FDG-PET/CT), and (18) F-FDG-PET combined with ceCT ((18) F-FDG-PET/ceCT) to determine the accuracy for detection of residual/recurrent disease after flap reconstruction for OCSCC.
  
  
  METHODS
  Two readers (R1, R2) retrospectively reviewed a total of 27 (18) F-FDG-PET/ceCT scans in patients after resection of stage II to IV OCSCC. They recorded the presence of local persistence/recurrence (LR), lymph node metastasis, or distant metastasis independently for ceCT, (18) F-FDG-PET/CT, and (18) F-FDG-PET/ceCT. Histological workup, imaging follow-up, or clinical follow-up served as the standard of reference. Maximum standardized uptake value (SUVmax) was evaluated to discriminate between physiological uptake and LR.
  
  
  RESULTS
  The highest accuracy to detect LR was achieved with (18) F-FDG-PET/ceCT, with a sensitivity/specificity of 88%/89% and 88%/79% for R1 and R2, respectively, as compared to ceCT with 75%/79% for R1 and 88%/68% for R2 and (18) F-FDG-PET/CT with 88%/58% for both R1 and R2. Receiver-operating-characteristic analysis determined a cutoff value for SUVmax of 7.2, yielding a sensitivity and specificity of 75% and 94%, respectively, to distinguish LR from physiological (18) F-FDG uptake.
  
  
  CONCLUSIONS
  (18) F-FDG-PET/ceCT seems to be the most reliable tool for locoregional surveillance of OCSCC patients after resection and reconstruction.
  
  
  METHODS
  4.
authors.affiliation: Department of Medical Radiology, Division of Nuclear Medicine.
authors.forename: Julian
authors.initials: J
authors.lastname: Müller
authors.affiliation: Department of Medical Radiology, Division of Nuclear Medicine.|Department of Medical Radiology, Clinic of Neuroradiology.
authors.forename: Martin
authors.initials: M
authors.lastname: Hüllner
authors.affiliation: Department of Radiology and Nuclear Medicine, Lucerne Cantonal Hospital, Lucerne.
authors.forename: Klaus
authors.initials: K
authors.lastname: Strobel
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich.
authors.forename: Gerhard F
authors.initials: GF
authors.lastname: Huber
authors.affiliation: Department of Medical Radiology, Division of Nuclear Medicine.
authors.forename: Irene A
authors.initials: IA
authors.lastname: Burger
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Microvascular Reconstruction, University Hospital Basel, Basel, Switzerland.
authors.forename: Stephan K
authors.initials: SK
authors.lastname: Haerle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D011184:Postoperative Period; D012372:ROC Curve; D019275:Radiopharmaceuticals; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG-PET/CT; flap; follow-up; head and neck cancer; oral cavity; reconstruction