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Value of Fluoro-2-Deoxy-D-Glucose-Positron Emission Tomography for Detecting Metastatic Lesions in Head and Neck Cancer
- Source :
- American Journal of Clinical Oncology. 35:311-315
- Publication Year :
- 2012
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2012.
-
Abstract
- OBJECTIVES The role of positron emission tomography (PET) scans in the staging of head and neck cancer (HNC) is unclear. The National Comprehensive Cancer Network guidelines do not recommend routine metastatic workup beyond physical examination, chest x-ray, and laboratory tests. The purpose of this report is to examine the accuracy of staging PET scans for detecting distant metastatic disease in patients with HNC. METHODS Retrospective review of 182 consecutive newly diagnosed HNC patients who had a staging PET scan at Thomas Jefferson University Hospital between 2003 and 2007. RESULTS The overall incidence of confirmed distant metastatic disease in this population was 5.0%. About 26 of the staging PET scans had areas suspicious for a metastatic lesion(s). Of total, 23 patients were further evaluated with imaging and/or biopsy, revealing 9 (39%) true positives, and 14 (60%) false positives. Of the 156 negative PET scans, there was 1 false negative and 155 true negatives. Thus, the sensitivity of PET was 90% and specificity was 92%. Positive predictive value was 39% and negative predictive value was 99.4%. No patients with pre-PET clinical stage I or II cancer had confirmed distant metastases. The only statistically significant predictor for metastatic disease was clinical stage IV versus all other stages (P=0.03). CONCLUSIONS Given the marked differences in the treatment of locally advanced/nonmetastatic HNC versus metastatic HNC, we recommend PET for clinical stage IV disease. Although the sensitivity, specificity, and negative predictive value rates were acceptable, the positive predictive value was suboptimal. Patients found to have a PET scan "positive" for metastatic disease require confirmatory imaging or ideally biopsy.
- Subjects :
- Cancer Research
medicine.medical_specialty
Population
Physical examination
Adenocarcinoma
Fluorodeoxyglucose F18
Biopsy
False positive paradox
medicine
Humans
education
Neoplasm Staging
Retrospective Studies
education.field_of_study
medicine.diagnostic_test
business.industry
Incidence (epidemiology)
Head and neck cancer
Cancer
Prognosis
medicine.disease
Carcinoma, Adenoid Cystic
Magnetic Resonance Imaging
Oncology
Head and Neck Neoplasms
Positron emission tomography
Positron-Emission Tomography
Carcinoma, Squamous Cell
Radiology
Neoplasm Recurrence, Local
Radiopharmaceuticals
Tomography, X-Ray Computed
business
Subjects
Details
- ISSN :
- 02773732
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- American Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....5d7c38eae91b27406f467d8441c3122e