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Clinical utility of PET/CT in the evaluation of head and neck squamous cell carcinoma with an unknown primary: A prospective clinical trial

✍ Scribed by Luke Rudmik; Harold Y. Lau; T. Wayne Matthews; J. Douglas Bosch; Reinhard Kloiber; Christine P. Molnar; Joseph C. Dort

Publisher: John Wiley and Sons
Year: 2010
Tongue: English
Weight: 206 KB
Volume: 33
Category: Article
ISSN: 1043-3074
DOI: 10.1002/hed.21566

No coin nor oath required. For personal study only.

✦ Synopsis

Abstract

Background

Metastatic head and neck squamous cell carcinoma with an unknown primary is an uncommon but important problem. PET/CT, as an adjunct to diagnosis, is potentially useful but has never been studied in a prospective, single‐blinded clinical trial.

Methods

In all, 20 subjects with cervical metastases from an unknown head and neck primary were enrolled in a prospective clinical trial. A standard protocol was used in both clinic and operating room (OR). Study surgeons were blinded to the PET/CT result upon completion of the standard work‐up.

Results

PET/CT increased the detection of a primary site from 25% to 55% (5 vs 11 subjects). This difference was statistically and clinically significant (p = .03, McNemar's test). There was 1 false negative PET/CT scan.

Conclusions

An unknown primary should be diagnosed only after a complete head and neck examination, flexible endoscopy, and CT or MRI. PET/CT performed prior to panendoscopy will increase the diagnostic yield in the unknown head and neck primary population, leading to more targeted, and less morbid, treatment. © 2010 Wiley Periodicals, Inc. Head Neck, 2011

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