title: FDG-PET/contrast-enhanced CT as a post-treatment tool in head and neck squamous cell carcinoma: comparison with FDG-PET/non-contrast-enhanced CT and contrast-enhanced CT.
abstract: OBJECTIVE
  To evaluate the accuracy of PET/CT using (18)F-fluorodeoxyglucose (FDG) with IV contrast for suspected recurrent head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  One hundred and seventy patients previously treated for HNSCC underwent PET/CT, consisting of non-contrast-enhanced and contrast-enhanced CT, to investigate suspected recurrence. Diagnostic performance of PET/contrast-enhanced CT (PET/ceCT), PET/non-contrast-enhanced CT (PET/ncCT) and contrast-enhanced CT (ceCT) for local or regional recurrence, distant metastasis, overall recurrence and second primary cancer was evaluated. The reference standard included histopathology, treatment change and imaging follow-up.
  
  
  RESULTS
  The patient-based areas under the receiver operating characteristic curves (AUC) for ceCT, PET/ncCT and PET/ceCT were 0.82, 0.96 and 0.98 for local recurrence, 0.73, 0.86 and 0.86 for regional recurrence, 0.86, 0.91 and 0.92 for distant metastasis, 0.72, 0.86 and 0.87 for overall recurrence, and 0.86, 0.89 and 0.91 for a second primary cancer. Both PET/ceCT and PET/ncCT statistically showed larger AUC than ceCT for recurrence, and the difference between PET/ceCT and PET/ncCT for local recurrence reached a significant level (p = 0.039). The accuracy of PET/ceCT for diagnosing overall recurrence was high, irrespective of the time interval after the last treatment (83.3-94.1 %).
  
  
  CONCLUSIONS
  FDG-PET/CT was a more accurate HNSCC restaging tool than ceCT. The added value of ceCT at FDG-PET/CT is minimal.
  
  
  CONCLUSIONS
  • FDG-PET/CT is a more accurate post-treatment surveillance tool than ceCT for HNSCC. • FDG-PET/ceCT was useful, irrespective of the time interval after the last treatment. • FDG-PET/ceCT showed high negative predictive value and limited positive predictive value. • The added value of ceCT at FDG-PET/CT is minimal and likely not clinically relevant.
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. ysue1215@ktj.biglobe.ne.jp.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Suenaga
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. kitajima@med.kobe-u.ac.jp.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kitajima
authors.affiliation: Department of Radiology, Division of Radiation Oncology, Kobe University Graduate, School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. takeaki@med.kobe-u.ac.jp.
authors.forename: Takeaki
authors.initials: T
authors.lastname: Ishihara
authors.affiliation: Department of Radiology, Division of Radiation Oncology, Kobe University Graduate, School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. yuunasasaki@hotmail.com.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Sasaki
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate, School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. naokies1964jp@gmail.com.
authors.forename: Naoki
authors.initials: N
authors.lastname: Otsuki
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate, School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. buken@gmail.com.
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Nibu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. minamina@med.kobe-u.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Minamikawa
authors.affiliation: Department of Medical Oncology and Hematology, Kobe University Hospital, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. nkiyota@med.kobe-u.ac.jp.
authors.forename: Naomi
authors.initials: N
authors.lastname: Kiyota
authors.affiliation: Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan. sugimura@med.kobe-u.ac.jp.
authors.forename: Kazuro
authors.initials: K
authors.lastname: Sugimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy; D003287:Contrast Media; D005145:Face / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006257:Head / Q000000981:diagnostic imaging; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods*; D012372:ROC Curve; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000077195:Squamous Cell Carcinoma of Head and Neck; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG; Enhanced CT; Head and neck squamous cell carcinoma (HNSCC); Positron emission tomography/computed tomography (PET/CT); Recurrence