title: 18F-FDG PET/CT surveillance for the detection of recurrence in patients with head and neck cancer.
abstract: Posttreatment detection of recurrence may lead to salvage treatment and prognostic prediction in patients with head and neck squamous cell carcinoma (HNSCC). We evaluated the diagnostic and prognostic values of18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) after definitive treatment of HNSCC.
  
  
  
  This prospective study included 278 consecutive patients who underwent curative surgery (n = 143, 51.4%) or definitive radiotherapy/chemoradiotherapy (n = 135, 48.6%) for previously untreated HNSCC. The patients were regularly followed up and evaluated by18F-FDG PET/CT, head and neck CT/magnetic resonance imaging (MRI), and chest CT at regular intervals after treatment. The imaging interpretations were compared with the histological results for recurrence. Receiver operating characteristics curves analysis, McNemar's test and logistic regression using generalised estimating equations were used to compare the diagnostic accuracy of18F-FDG PET/CT and standard imaging of CT/MRI or chest CT, and a Cox proportional hazards model was used to assess the prognostic value of PET/CT.
  
  
  
  During a median follow-up of 44 months (range, 24-62 months), 73 patients (26.3%) had recurrence or persistent diseases. The area under curves for18F-FDG PET/CT and CT/MRI were 0.975 (0.964-0.992) and 0.789 (0.713-0.874), respectively (P < 0.001).18F-FDG PET/CT detected 65 of 66 recurrences (98.5%) not suggested by physical examination and endoscopy. Positive findings on18F-FDG PET/CT scans were independent predictors of poorer cancer-specific and overall survival outcomes (P < 0.01).
  
  
  
  Posttreatment18F-FDG PET/CT surveillance helps to properly detect recurrence and to predict the survival following treatment of HNSCC.
authors.affiliation: Department of Otolaryngology, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Shin-Ae
authors.initials: SA
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: rohjl@amc.seoul.kr.
authors.forename: Jong-Lyel
authors.initials: JL
authors.lastname: Roh
authors.affiliation: Department of Nuclear Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Department of Otolaryngology, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Soon Yuhl
authors.initials: SY
authors.lastname: Nam
authors.affiliation: Department of Otolaryngology, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: (18)F-FDG PET/CT; Head and neck squamous cell carcinoma; Recurrence; Surveillance; Survival