PURPOSE: The aim of our study was to assess the utility of positron emission tomography (PET) and 2 fluoro-2-deoxy-D-glucose coupled with neck CT compared with contrast-enhanced CT in predicting persistent cancer either at the primary site or cervical lymphatics in patients with oropharyngeal cancer treated with concurrent chemoradiation METHODS: Thirty consecutive patients underwent clinical examination, PET-CT, and contrast-enhanced CT to assess response after the completion of the treatment. The outcome variable was positive tissue diagnosis or negative disease at 6 months. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for the primary site as well as cervical disease. RESULTS: Contrast-enhanced CT alone showed the best accuracy in detecting disease at the primary site after treatment (85.7%). Accuracy in evaluating residual tumor in the cervical lymphatics for contrast-enhanced CT and PET-CT was 59.3% and 74.1%, respectively. For evaluating the neck, PET-CT and contrast-enhanced CT demonstrated 100% NPV, but the PPV was 36.3% and 26.6%, respectively. CONCLUSIONS: In this preliminary study, PET-CT seems to be superior to contrast-enhanced CT in predicting persistent disease in the neck after chemoradiation for oropharyngeal or unknown primary cancer, but not at the primary site. However, the possibility of a false-positive result in the neck remains high, and thus overtreatment may result. Even more concerning are the false-negative results. Larger, prospective studies will be important in defining the role of PET-CT in obviating the need for salvage neck dissections after chemoradiation.
PURPOSE: The aim of our study was to assess the utility of positron emission tomography (PET) and 2 fluoro-2-deoxy-D-glucose coupled with neck CT compared with contrast-enhanced CT in predicting persistent cancer either at the primary site or cervical lymphatics in patients with oropharyngeal cancer treated with concurrent chemoradiation METHODS: Thirty consecutive patients underwent clinical examination, PET-CT, and contrast-enhanced CT to assess response after the completion of the treatment. The outcome variable was positive tissue diagnosis or negative disease at 6 months. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for the primary site as well as cervical disease. RESULTS: Contrast-enhanced CT alone showed the best accuracy in detecting disease at the primary site after treatment (85.7%). Accuracy in evaluating residual tumor in the cervical lymphatics for contrast-enhanced CT and PET-CT was 59.3% and 74.1%, respectively. For evaluating the neck, PET-CT and contrast-enhanced CT demonstrated 100% NPV, but the PPV was 36.3% and 26.6%, respectively. CONCLUSIONS: In this preliminary study, PET-CT seems to be superior to contrast-enhanced CT in predicting persistent disease in the neck after chemoradiation for oropharyngeal or unknown primary cancer, but not at the primary site. However, the possibility of a false-positive result in the neck remains high, and thus overtreatment may result. Even more concerning are the false-negative results. Larger, prospective studies will be important in defining the role of PET-CT in obviating the need for salvage neck dissections after chemoradiation.
Authors: Jon Cacicedo; Arturo Navarro; Olga Del Hoyo; Alfonso Gomez-Iturriaga; Filippo Alongi; Jose A Medina; Olgun Elicin; Andrea Skanjeti; Francesco Giammarile; Pedro Bilbao; Francisco Casquero; Berardino de Bari; Alan Dal Pra Journal: Br J Radiol Date: 2016-08-02 Impact factor: 3.039
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Authors: Shlomo A Koyfman; Nofisat Ismaila; Doug Crook; Anil D'Cruz; Cristina P Rodriguez; David J Sher; Damian Silbermins; Erich M Sturgis; Terance T Tsue; Jared Weiss; Sue S Yom; F Christopher Holsinger Journal: J Clin Oncol Date: 2019-02-27 Impact factor: 44.544
Authors: Jason Y K Chan; Giuseppe Sanguineti; Jeremy D Richmon; Shanthi Marur; Christine G Gourin; Wayne Koch; Christine H Chung; Harry Quon; Justin A Bishop; Nafi Aygun; Nishant Agrawal Journal: Arch Otolaryngol Head Neck Surg Date: 2012-11
Authors: Benjamin J Moeller; Vishal Rana; Blake A Cannon; Michelle D Williams; Erich M Sturgis; Lawrence E Ginsberg; Homer A Macapinlac; J Jack Lee; K Kian Ang; K S Clifford Chao; Gregory M Chronowski; Steven J Frank; William H Morrison; David I Rosenthal; Randal S Weber; Adam S Garden; Scott M Lippman; David L Schwartz Journal: J Clin Oncol Date: 2009-03-30 Impact factor: 44.544