title: Diagnostic Accuracy of Follow-Up FDG PET or PET/CT in Patients With Head and Neck Cancer After Definitive Treatment: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  The purpose of this study was to assess the diagnostic performance of FDG PET or PET/CT for detection of local, regional, and distant recurrences in the follow-up of patients with head and neck cancer who underwent definitive treatment.
  
  
  METHODS
  A systematic search was performed in MEDLINE and Cochrane Library (updated September 2014) to identify relevant published studies. Studies investigating the accuracy of FDG PET/CT that were performed at least 4 months after therapy were included. Two authors independently screened all retrieved articles, selected studies that met the inclusion criteria, and extracted the data. Histopathologic confirmation or clinical follow-up of at least 6 month (or both) was considered as the reference standard.
  
  
  RESULTS
  Twenty-three studies constituting a total of 2247 FDG PET/CT examinations met our inclusion criteria. The pooled sensitivity and specificity of follow-up PET/CT for detection of recurrence were 0.92 (95% CI, 0.90-0.94), and 0.87 (95% CI, 0.82-0.91), respectively. The pooled sensitivity and specificity of scans performed 4-12 months after treatment were 0.95 (95% CI, 0.91-0.97) and 0.78 (95% CI, 0.70-0.84), respectively. Similar estimates for scans performed at or more than 12 months after treatment were 0.92 (95% CI, 0.85-0.96) and 0.91 (95% CI, 0.78-0.96), respectively. The overall accuracy of FDG PET/CT in detecting recurrence is higher in patients without suspicion of recurrence before the scan compared with the patients with suspected recurrence.
  
  
  CONCLUSIONS
  The high diagnostic performance of FDG PET/CT in detecting recurrence in curatively treated patients with head and neck cancer supports its use in clinical practice for patient follow-up. Further studies are needed to evaluate the prognostic utility of PET/CT in the follow-up of head and neck cancer.
authors: 1 Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3235, Baltimore, MD 21287.
authors: Sara
authors: S
authors: Sheikhbahaei
authors: 1 Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3235, Baltimore, MD 21287.
authors: Mehdi
authors: M
authors: Taghipour
authors: 1 Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3235, Baltimore, MD 21287.
authors: Rubina
authors: R
authors: Ahmad
authors: 2 Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.|3 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Carole
authors: C
authors: Fakhry
authors: 4 Department of Radiation Oncology and Radiation Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD.
authors: Ana P
authors: AP
authors: Kiess
authors: 5 Department of Medical Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.
authors: Christine H
authors: CH
authors: Chung
authors: 1 Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3235, Baltimore, MD 21287.|2 Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.|5 Department of Medical Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.|6 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Rathan M
authors: RM
authors: Subramaniam
mesh_terms: D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG PET; PET/CT; follow-up; head and neck neoplasm; meta-analysis; recurrence; sensitivity and specificity