Positron emission tomography–computed tomography surveillance for the node-positive neck after chemoradiotherapy

✍ Scribed by Amy G. Rabalais; Rohan Walvekar; Daniel Nuss; Andrew McWhorter; Charles Wood; Robert Fields; Donald E. Mercante; Anna M. Pou

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 85 KB
• Volume: 119
• Category: Article
• ISSN: 0023-852X
• DOI: 10.1002/lary.20201

✦ Synopsis

Abstract

Objectives/Hypothesis:

To review our results with positron emission tomography and computed tomography fusion imaging (PET‐CT) surveillance of the postchemoradiotherapy neck in patients with advanced head and neck squamous cell carcinoma.

Study Design:

Retrospective.

Methods:

Four hundred twenty‐eight patients with advanced head and neck squamous cell carcinoma were treated with nonsurgical therapy from September 2002 to March 2007 and followed with post‐treatment PET‐CT surveillance of the neck. Fifty‐two patients meeting inclusion criteria were analyzed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET‐CT were determined.

Results:

Ten patients had a positive post‐treatment PET‐CT for residual neck disease, and 42 patients had negative scans. The NPV and PPV were 100% and 40%, respectively. The sensitivity, specificity, and accuracy were 100%, 87.5%, and 88%, respectively.

Conclusions:

Planned neck dissection can be deferred with a negative post‐treatment PET‐CT. Assuming a complete response at the primary site and a negative PET‐CT scan, there may be a role for serial PET‐CT surveillance in patients with residual palpable cervical lymphadenopathy. Laryngoscope, 2009