18F-FDG PET-CT in the Management of Patients Receiving Definitive Radiotherapy for Malignancies of the Head and Neck

Author:

Franc Benjamin L.12,DeLemos Christi3,Jones Christopher4

Affiliation:

1. Diagnostic Imaging, Sutter Medical Group, 3161 L Street, Sacramento, CA 95814, USA

2. University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA

3. Radiological Associates of Sacramento Medical Group, 1500 Expo Parkway, Sacramento, CA 95815, USA

4. Radiation Oncology Center, Sutter Medical Group, 2800 L Street, Sacramento, CA 95816, USA

Abstract

The study investigated the utility and timing of 18F-FDG PET-CT to evaluate for residual/recurrent or metastatic HNC in patients treated with definitive intensity modulated radiation therapy (IMRT) with or without chemotherapy, planned with 18F-FDG PET-CT. The incidence and timing of locoregional recurrence, distant metastatic disease, new primary malignancies, and death were evaluated in 261 patients retrospectively. Findings were classified based on pathology or clinical follow-up and the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET-CT were determined overall as well as at the time of each 18F-FDG PET-CT. The overall accuracy for 18F-FDG PET in the detection of residual/recurrent malignancy or metastatic disease was 96.4%. Of those in whom cancer recurred locally, 57% were identified based on physical examination and other imaging findings and 43% were identified initially on 18F-FDG PET-CT surveillance imaging when no disease was evident clinically. 18F-FDG PET-CT has a high diagnostic capability of detecting residual/recurrent malignancy or malignant metastatic disease in patients with HNC following IMRT ± concurrent chemotherapy, supporting 18F- FDG PET-CT’s use to evaluate patients for recurrent malignancy in the post-IMRT period, even without clinical evidence of disease.

Publisher

Hindawi Limited

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