title: Detecting Residual/Recurrent Head Neck Squamous Cell Carcinomas Using PET or PET/CT: Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of positron emission tomography (PET) and PET/computed tomography (CT) for detecting residual and/or recurrent local and regional disease and distant metastases in patients with head and neck squamous cell carcinomas (HNSCCs) following radiotherapy with or without chemotherapy.
  
  
  METHODS
  A systematic review with no language restrictions was conducted using PREMEDLINE, MEDLINE, EMBASE, and Google Scholar.
  
  
  METHODS
  Only prospective studies with histopathological and/or clinical follow-up that assessed the diagnostic accuracy of PET and PET/CT in detecting residual and/or recurrent disease following radiotherapy with or without chemotherapy in patients with HNSCCs were included.
  
  
  RESULTS
  Twenty-seven studies were identified. The pooled sensitivity and specificity of PET and PET/CT for detecting residual or recurrent disease at the primary site was 86.2% and 82.3%, respectively. For residual and recurrent neck disease, the sensitivity and specificity were 72.3% and 88.3%, while for distant metastases, the values were 84.6% and 94.9%.
  
  
  CONCLUSIONS
  PET and PET/CT are highly accurate in detecting residual and/or recurrent HNSCC. PET/CT is more specific than PET alone. Specificity is also greater for scans performed more than 12 weeks after radiotherapy with or without chemotherapy. The authors support the use of PET/CT after 12 weeks posttreatment for the assessment of residual or recurrent disease.
authors.affiliation: Sydney Medical School, The University of Sydney, New South Wales, Australia.
authors.forename: Phylannie K F
authors.initials: PK
authors.lastname: Cheung
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia drronaldchin@gmail.com.
authors.forename: Ronald Y
authors.initials: RY
authors.lastname: Chin
authors.affiliation: The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia.
authors.forename: Guy D
authors.initials: GD
authors.lastname: Eslick
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000628:therapy; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
keywords: locoregional neoplasm recurrence; meta-analysis; positron emission tomography; squamous cell carcinoma of the head and neck; systematic review