Mehdi Taghipour1, Sara Sheikhbahaei1, Rick Wray1, Nishant Agrawal2, Jeremy Richmon2, Hyunseok Kang3, Rathan M Subramaniam1,2,3,4. 1. 1 Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, 601 N Caroline St, JHOC 3235, Baltimore, MD 21287. 2. 2 Department of Otolaryngology and Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD. 3. 3 Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD. 4. 4 Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Abstract
OBJECTIVE: The purpose of this study was to assess the value of posttreatment FDG PET/CT in patients with squamous cell carcinoma of the head and neck (HNSCC) treated with primary surgical resection with or without adjuvant concurrent chemoradiotherapy. MATERIALS AND METHODS: A total of 98 HNSCC patients were treated with primary surgical resection and had undergone PET/CT within 6 months of treatment completion. The accuracy of the scans and the added value to clinical assessment and impact on management were established based on the clinical information before and after each scan. Overall survival of patients was estimated with Kaplan-Meier curves. RESULTS: Of the total 98 scans, 25 (25.5%) were interpreted as positive and 73 (74.5%) as negative. The sensitivity of posttreatment PET/CT was 80.0%; specificity, 89.5%; positive predictive value, 66.7%; negative predictive value, 94.4%; and accuracy, 87.5%. These scans were helpful in excluding tumor in 31.8% of patients with clinical suspicion of residual disease and identifying suspected residual disease in 13.2% of patients with no prior clinical suspicion. Multivariate regression analysis showed that tumor size, grade (p = 0.041), scan type (p = 0.002), and scan result (p = 0.005) were independent covariates associated with overall survival. Kaplan-Meier analysis showed a significant difference and association in overall survival between patients with a positive versus a negative posttherapy PET/CT scan result (hazard ratio, 5.65; 95% CI, 2.48-12.83; log rank Mantel-Cox p < 0.001). CONCLUSION: Posttreatment FDG PET/CT results had a high negative predictive value, added value to clinical assessment of 35% of patients, influenced subsequent management, and were associated with survival outcome of HNSCC patients treated with primary surgical resection.
OBJECTIVE: The purpose of this study was to assess the value of posttreatment FDG PET/CT in patients with squamous cell carcinoma of the head and neck (HNSCC) treated with primary surgical resection with or without adjuvant concurrent chemoradiotherapy. MATERIALS AND METHODS: A total of 98 HNSCCpatients were treated with primary surgical resection and had undergone PET/CT within 6 months of treatment completion. The accuracy of the scans and the added value to clinical assessment and impact on management were established based on the clinical information before and after each scan. Overall survival of patients was estimated with Kaplan-Meier curves. RESULTS: Of the total 98 scans, 25 (25.5%) were interpreted as positive and 73 (74.5%) as negative. The sensitivity of posttreatment PET/CT was 80.0%; specificity, 89.5%; positive predictive value, 66.7%; negative predictive value, 94.4%; and accuracy, 87.5%. These scans were helpful in excluding tumor in 31.8% of patients with clinical suspicion of residual disease and identifying suspected residual disease in 13.2% of patients with no prior clinical suspicion. Multivariate regression analysis showed that tumor size, grade (p = 0.041), scan type (p = 0.002), and scan result (p = 0.005) were independent covariates associated with overall survival. Kaplan-Meier analysis showed a significant difference and association in overall survival between patients with a positive versus a negative posttherapy PET/CT scan result (hazard ratio, 5.65; 95% CI, 2.48-12.83; log rank Mantel-Cox p < 0.001). CONCLUSION: Posttreatment FDG PET/CT results had a high negative predictive value, added value to clinical assessment of 35% of patients, influenced subsequent management, and were associated with survival outcome of HNSCCpatients treated with primary surgical resection.
Entities:
Keywords:
PET/CT; head and neck; postsurgical assessment; squamous cell carcinoma; surgical resection; survival
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: Shanmugappiriya Sivarajah; Andre Isaac; Tim Cooper; Han Zhang; Lakshmi Puttagunta; Jonathan Abele; Vincent Biron; Jeffery Harris; Hadi Seikaly; Daniel A O' Connell Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-11-01 Impact factor: 6.223