Mehdi Taghipour1, Charles Marcus1, Joseph Califano2, Carole Fakhry2,3, Rathan M Subramaniam1,2,4,5. 1. Russell H Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD, USA. 2. Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA. 3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 4. Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD, USA. 5. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Abstract
INTRODUCTION: To establish the accuracy of follow-up fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT and the impact of FDG PET/CT result on management decisions and patient outcome prediction (overall and progression free survival) in human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma (SCC). PATIENTS AND METHODS: We included 96 HPV-positive oropharyngeal SCC (OPSCC) patients with 254 follow-up PET/CT scans in the study. The PET/CT result accuracy was established with histopathology or 6-month clinical follow-up as reference standard. The impact on change in management was established for each follow-up PET/CT scan. Overall survival was evaluated using Kaplan-Meier plots with a Log-rank test. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the follow-up FDG-PET/CT were 97.0%, 92.5%, 67.0%, 99.5% and 93.1%, respectively. Follow-up PET/CT results were helpful in excluding tumour in 22% (9/41) of scans performed with prior clinical suspicion of disease and identified potential disease in 9.9% (21/213) scans performed without prior clinical suspicion. There was a change in management after 12.6% (32/254) scans. In 84.3% (214/254) scans, the patients were either observed or the same treatment was continued. The overall survival differed significantly between patients with a negative versus positive follow-up scan (log rank P < 0.001). The median progression free survival was 28 months, if the first follow-up scan performed within 6-12 months post-treatment completion was negative. CONCLUSION: Follow-up FDG PET/CT scans have an impact on the management plan and add value to clinical assessment in patients with HPV-positive OPSCC.
INTRODUCTION: To establish the accuracy of follow-up fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT and the impact of FDG PET/CT result on management decisions and patient outcome prediction (overall and progression free survival) in human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma (SCC). PATIENTS AND METHODS: We included 96 HPV-positive oropharyngeal SCC (OPSCC) patients with 254 follow-up PET/CT scans in the study. The PET/CT result accuracy was established with histopathology or 6-month clinical follow-up as reference standard. The impact on change in management was established for each follow-up PET/CT scan. Overall survival was evaluated using Kaplan-Meier plots with a Log-rank test. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the follow-up FDG-PET/CT were 97.0%, 92.5%, 67.0%, 99.5% and 93.1%, respectively. Follow-up PET/CT results were helpful in excluding tumour in 22% (9/41) of scans performed with prior clinical suspicion of disease and identified potential disease in 9.9% (21/213) scans performed without prior clinical suspicion. There was a change in management after 12.6% (32/254) scans. In 84.3% (214/254) scans, the patients were either observed or the same treatment was continued. The overall survival differed significantly between patients with a negative versus positive follow-up scan (log rank P < 0.001). The median progression free survival was 28 months, if the first follow-up scan performed within 6-12 months post-treatment completion was negative. CONCLUSION: Follow-up FDG PET/CT scans have an impact on the management plan and add value to clinical assessment in patients with HPV-positive OPSCC.
Authors: Mehdi Taghipour; Esther Mena; Matthew J Kruse; Sara Sheikhbahaei; Rathan M Subramaniam Journal: Nucl Med Commun Date: 2017-03 Impact factor: 1.690
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: Travis C Salzillo; Nicolette Taku; Kareem A Wahid; Brigid A McDonald; Jarey Wang; Lisanne V van Dijk; Jillian M Rigert; Abdallah S R Mohamed; Jihong Wang; Stephen Y Lai; Clifton D Fuller Journal: Semin Radiat Oncol Date: 2021-10 Impact factor: 5.421