Role of [18F]-FDG PET-CT in the management of the head and neck cancers

Objectives : To evaluate the impact of (F-18)-FDG PET/CT image fusion in the management of carcinomas of the upper aero-digestive tract. Methods : This retrospective study included 169 patients with squamous cell cacinoma of the upper aerodigestive tract who underwent a PET/CT for: initial staging (n = 47), cervical lymphadenopathy from an unknown primary (n = 22), post treatment surveillance (n = 68) and detection of recurrent cancer (n = 32). Results of PET/CT were compared with those of standard workup (CT scan of head, neck and chest and abdominal ultrasound). Histology and clinical follow-up were used as gold-standard. Results : PET/CT was more accurate than standard workup for 6.4 % of patients for the initial staging, 18,2 % of Patients for cervical lymphadenopathy from an unknown primary, 20,6 176 ofpatients for post-treatment surveillance and 25 96, of patients for detection of cancer recurrence. In all patients, 17,9 176 of FDG uptake foci found by PET/CT were false-positives. Conclusion : PETICT is a reliable tool for the management of carcinomas of the upper aerodigestive tract. The high rate of false-positive findings represents the main limitation of this exam.