Evaluation of suspected local recurrence in head and neck cancer: A comparison between PET and PET/CT for biopsy proven lesions

Halpern, Benjamin S.; Yeom, Kristen; Fueger, Barbara J.; Lufkin, Robert B.; Czernin, Johannes; Allen-Auerbach, Martin

doi:10.1016/j.ejrad.2006.11.037

« Previous Next »European Journal of Radiology
Volume 62, Issue 2 , Pages 199-204, May 2007

Evaluation of suspected local recurrence in head and neck cancer: A comparison between PET and PET/CT for biopsy proven lesions

Benjamin S. Halpern
- Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center/Nuclear Medicine, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095-6948, USA
- Department of Radiology, Division of Musculo-Skeletal and Head and Neck Radiology, Medical University Vienna, Vienna 1090 Währinger Gürtel 18-20, Austria
- Corresponding author at: Department of Radiology, Division of Musculo-Skeletal and Head and Neck Radiology, Medical University Vienna, Vienna 1090 Währinger Gürtel 18-20, Austria. Tel.: +43 1 40400 4818; fax: +43 1 40400 4898.
Kristen Yeom
- Department of Radiological Sciences, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095-1721, USA
Barbara J. Fueger
- Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center/Nuclear Medicine, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095-6948, USA
Robert B. Lufkin
- Department of Radiological Sciences, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095-1721, USA
Johannes Czernin
- Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center/Nuclear Medicine, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095-6948, USA
Martin Allen-Auerbach
- Department of Molecular and Medical Pharmacology, Ahmanson Biological Imaging Center/Nuclear Medicine, UCLA School of Medicine, 10833 Le Conte Avenue, Los Angeles, CA 90095-6948, USA
- Senior author: UCLA School of Medicine, Nuclear Medicine, 105 CHS, 10833 Le Conte Avenue, Los Angeles, CA 90095-6942, USA. Tel.: +1 310 794 3226; fax: +1 310 206 4899.

Received 2 January 2006; received in revised form 6 June 2006; accepted 24 November 2006.

Abstract

Background

¹⁸F-FDG PET has a high accuracy for re-staging of head and neck cancer. The purpose of this study was to determine whether the diagnostic accuracy can be further improved with integrated PET/CT.

Materials and methods

Forty-nine patients with a mean age of 59±18 years were studied retrospectively. Histo-pathological verification was available either from complete tumor resection with or without lymph node dissection (n=27) or direct endoscopic biopsy (n=16) or ultrasound guided biopsy (n=6). Two reviewers blinded to the pathological findings read all PET images in consensus. An experienced radiologist was added for the interpretation of the PET/CT images.

Results

Tissue verification was available for 110 lesions in 49 patients. Sixty-seven lesions (61%) were biopsy positive and 43 (39%) were negative for malignant disease. PET and PET/CT showed an overall accuracy for cancer detection of 84 and 88% (p=0.06), respectively. Sensitivity and specificity for PET were 78 and 93% versus 84 (p=NS) and 95% (p=NS) with PET/CT. A patient-by-patient analysis yielded a sensitivity, specificity and accuracy for PET of 80, 56 and 76%, compared to 88% (p=NS), 78% (p=NS) and 86% (p=0.06) for PET/CT.

Conclusion

The results of this study indicate that PET/CT does not significantly improve the detection of recurrence of head and neck cancer. However, a trend towards improved accuracy was observed (p=0.06).

Keywords: Head and neck cancer, PET/CT, Re-staging