PURPOSE: Posttreatment follow-up for the recurrence of head and neck squamous cell carcinoma (HNSCC) is a diagnostic challenge. Tissue distortion from radiation and surgery can obscure early detection of recurrence by conventional follow-up approaches such as physical examination or conventional imaging. Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT is widely validated for the diagnosis of suspected recurrence. Moreover, we have shown in a previous prospective study the high effectiveness of FDG PET/CT in the assessment of subclinical recurrence 12 months after treatment. The aim of this prospective study was to evaluate the effectiveness of an earlier FDG PET/CT, at 6 months after the end of treatment. METHODS: All patients treated for histologically proven HNSCC from April 2009 to May 2012 at the University Hospital of Brest who did not show any findings suggestive of recurrence at 6 months of their usual follow-up underwent an FDG PET/CT examination. FDG PET/CT findings were correlated with histopathology or imaging follow-up. RESULTS: The study included 116 patients. FDG PET/CT examinations were performed within a mean period ± SD of 5.6 ± 1.8 months after treatment. FDG PET/CT examinations exhibited abnormal FDG uptake in 34 patients and found no suspected recurrence in 82 cases. Of these 82 FDG PET/CT considered as negative, only 1 had a recurrence. Among the 34 positive FDG PET/CT, 22 relapsed whereas 12 did not show evidence of recurrence. The sensitivity and specificity of FDG PET/CT in this study for the diagnosis of occult HNSCC recurrence were 96 (22/23) and 87 % (81/93), respectively. The positive predictive value was 65 % (22/34). The negative predictive value was 99 % (81/82). The overall accuracy was 89 % (103/116). Of the 116 patients, FDG PET/CT highlighted 22 (19 %) subclinical recurrences. CONCLUSION: Our study showed the high effectiveness of FDG PET/CT in the assessment of subclinical HNSCC recurrence 6 months after completion of treatment. These results confirmed that FDG PET/CT is more accurate than conventional follow-up physical examination alone in the assessment of recurrence after previous curative treatment for HNSCC, as we previously demonstrated in patients clinically asymptomatic at 12 months.
PURPOSE: Posttreatment follow-up for the recurrence of head and neck squamous cell carcinoma (HNSCC) is a diagnostic challenge. Tissue distortion from radiation and surgery can obscure early detection of recurrence by conventional follow-up approaches such as physical examination or conventional imaging. Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT is widely validated for the diagnosis of suspected recurrence. Moreover, we have shown in a previous prospective study the high effectiveness of FDG PET/CT in the assessment of subclinical recurrence 12 months after treatment. The aim of this prospective study was to evaluate the effectiveness of an earlier FDG PET/CT, at 6 months after the end of treatment. METHODS: All patients treated for histologically proven HNSCC from April 2009 to May 2012 at the University Hospital of Brest who did not show any findings suggestive of recurrence at 6 months of their usual follow-up underwent an FDG PET/CT examination. FDG PET/CT findings were correlated with histopathology or imaging follow-up. RESULTS: The study included 116 patients. FDG PET/CT examinations were performed within a mean period ± SD of 5.6 ± 1.8 months after treatment. FDG PET/CT examinations exhibited abnormal FDG uptake in 34 patients and found no suspected recurrence in 82 cases. Of these 82 FDG PET/CT considered as negative, only 1 had a recurrence. Among the 34 positive FDG PET/CT, 22 relapsed whereas 12 did not show evidence of recurrence. The sensitivity and specificity of FDG PET/CT in this study for the diagnosis of occult HNSCC recurrence were 96 (22/23) and 87 % (81/93), respectively. The positive predictive value was 65 % (22/34). The negative predictive value was 99 % (81/82). The overall accuracy was 89 % (103/116). Of the 116 patients, FDG PET/CT highlighted 22 (19 %) subclinical recurrences. CONCLUSION: Our study showed the high effectiveness of FDG PET/CT in the assessment of subclinical HNSCC recurrence 6 months after completion of treatment. These results confirmed that FDG PET/CT is more accurate than conventional follow-up physical examination alone in the assessment of recurrence after previous curative treatment for HNSCC, as we previously demonstrated in patients clinically asymptomatic at 12 months.
Authors: R J Wong; D T Lin; H Schöder; S G Patel; M Gonen; S Wolden; D G Pfister; J P Shah; S M Larson; D H Kraus Journal: J Clin Oncol Date: 2002-10-15 Impact factor: 44.544
Authors: N J Fischbein; O S AAssar; G R Caputo; M J Kaplan; M I Singer; D C Price; W P Dillon; R A Hawkins Journal: AJNR Am J Neuroradiol Date: 1998-08 Impact factor: 3.825
Authors: Allen S Ho; Gabriel J Tsao; Frank W Chen; Tianjie Shen; Michael J Kaplan; A Dimitrios Colevas; Nancy J Fischbein; Andrew Quon; Quynh-Thu Le; Harlan A Pinto; Willard E Fee; John B Sunwoo; Davud Sirjani; Wendy Hara; Mike Yao Journal: Cancer Date: 2012-12-07 Impact factor: 6.860
Authors: Martin Kunkel; Gregor J Förster; Torsten E Reichert; Jong-Hyeon Jeong; Peter Benz; Peter Bartenstein; Wilfried Wagner; Theresa L Whiteside Journal: Cancer Date: 2003-11-15 Impact factor: 6.860
Authors: Christiaan A Krabbe; Jan Pruim; Pieter U Dijkstra; Hans Balink; Bernard F van der Laan; Jan G de Visscher; Jan L Roodenburg Journal: J Nucl Med Date: 2009-11-12 Impact factor: 10.057
Authors: Louise Madeleine Risør; Annika Loft; Anne Kiil Berthelsen; Frederik Cornelius Loft; Andreas Ruhvald Madsen; Ivan Richter Vogelius; Andreas Kjær; Jeppe Friborg Journal: Eur Arch Otorhinolaryngol Date: 2019-10-23 Impact factor: 2.503
Authors: Minerva Becker; Arthur D Varoquaux; Christophe Combescure; Olivier Rager; Marc Pusztaszeri; Karim Burkhardt; Bénédicte M A Delattre; Pavel Dulguerov; Nicolas Dulguerov; Eirini Katirtzidou; Francesca Caparrotti; Osman Ratib; Habib Zaidi; Christoph D Becker Journal: Eur Radiol Date: 2017-08-15 Impact factor: 5.315