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Role of pretreatment 18FDG-PET/CT in surgical decision-making for head and neck cancers

✍ Scribed by N. Gopalakrishna Iyer; Jonathan R. Clark; Shahlini Singham; Jacqui Zhu

Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
420 KB
Volume
32
Category
Article
ISSN
1043-3074

No coin nor oath required. For personal study only.

✦ Synopsis

Abstract

Background

Despite widespread use, the utility of pretreatment positron emission tomography/computed tomography (PET/CT) remains undefined. In this study, we aim to determine its accuracy in nodal disease.

Methods

In all, 111 patients managed between 2003 and 2007 were analyzed.

Results

For squamous cell cancers (SCCs) with any increased nodal uptake (mild to high), sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) were 75%, 95%, 85%, and 90%. However, if PET was deemed positive for only moderate to high uptake, sensitivity, specificity, PPV, and NPV were 71%, 95%, 85%, and 89%. In patients undergoing elective neck dissection, the accuracy was lower: for any increased uptake, sensitivity, specificity, PPV, and NPV were 66%, 96%, 83%, and 92%, whereas for moderate to high uptake, these were 52%, 97%, 79%, and 89%.

Conclusions

Despite advances in PET/CT technology, these statistics suggest that PET/CT is not sufficiently accurate to direct superselective neck dissections, or to guide therapeutic decisions in the N0 neck. © 2010 Wiley Periodicals, Inc. Head Neck, 2010

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