POSITRON EMISSION TOMOGRAPHY IN SURVEILLANCE OF HEAD AND NECK SQUAMOUS CELL CARCINOMA AFTER DEFINITIVE CHEMORADIOTHERAPY

Background. We assessed the role of F-18-fluorodeoxy-glucose positron emission tomography (PET) in detecting head and neck squamous cell carcinoma (HNSCC) after definitive chemoradiotherapy (CRT). Methods, A prospective study presented 80 PET before and after CRT for 44 patients, including 44 first-time post-CRT scans performed between 12 and 17 weeks after radiotherapy completion, as well as 10 repeated scans in the subsequent follow-up. PET interpretations were compared with clinicopathologic outcomes. Results. PET demonstrated better performance than CT in post-CRT surveillance. Considering all 54 post-CRT PET scans, sensitivity for detecting primary tumors was 100%, specificity 93%, positive predictive value (PPV) 80%, and negative predictive value (NPV) 100%. For cervical diseases, sensitivity was 100%, specificity 98%, PPV 92%, and NPV 100%. For distant metastases, sensitivity was 100%, specificity 98%, PPV 86%, and Ni 100%. Conclusions. Negative PET readings were reliable for predicting free of HINSCC and helpful for selected patients in post-CRT surveillance. (C) 2009 Wiley Periodicals, Inc. Head Neck 31:442-451, 2009