Identification of distant metastases with PET-CT in patients with suspected recurrent head and neck cancer

Christine G. Gourin, Tammara Watts, Hadyn T. Williams, Vijay S. Patel, Paul A. Bilodeau, Teresa A. Coleman

Research output: Contribution to journalArticle

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Abstract

Objectives: To investigate the utility of positron-emission tomography/computed tomography (PET-CT) in identifying distant metastatic disease in patients with suspected recurrent head and neck squamous cell cancer (HNSCC). Study Design: Retrospective analysis. Methods: Retrospective analysis of 64 consecutive patients with suspected recurrent HNSCC following definitive treatment who underwent PET-CT imaging were eligible for inclusion. Patients with previous known distant metastatic disease were excluded. Results: The majority of patients (81%) had TNM stage III or IV disease. PET-CT was suspicious for pulmonary malignancy in 14 patients (22%) and indeterminate in 6 patients (9%). Pulmonary metastases or a new lung primary were present in 10 patients (16%): 7 of 14 patients with positive PET-CT scans (50%) and 3 of 50 patients with negative or indeterminate PET-CT scans (6%). Including nonpulmonary sites, the overall incidence of distant disease was 23% (15/64) with 20% (13/64) unsuspected prior to PET-CT. The sensitivity and specificity of PET-CT in predicting distant malignancy was 86% and 84%, respectively, with a positive predictive value of 60% and a negative predictive value of 95%. There was a significant correlation between standardized uptake value (SUV) on PET-CT and positive histology, with a mean SUV of 8.5 (range, 4.7-16.2) in patients with distant metastases compared with a mean SUV of 2.9 (range, 1.9-4.2) in patients with benign pathology (r=0.87, P<.0001).

Original languageEnglish (US)
Pages (from-to)703-706
Number of pages4
JournalLaryngoscope
Volume119
Issue number4
DOIs
StatePublished - Apr 1 2009

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Head and Neck Neoplasms
Neoplasm Metastasis
Squamous Cell Neoplasms
Lung
Positron Emission Tomography Computed Tomography
Head
Neoplasms
Histology
Retrospective Studies
Pathology
Sensitivity and Specificity

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Identification of distant metastases with PET-CT in patients with suspected recurrent head and neck cancer. / Gourin, Christine G.; Watts, Tammara; Williams, Hadyn T.; Patel, Vijay S.; Bilodeau, Paul A.; Coleman, Teresa A.

In: Laryngoscope, Vol. 119, No. 4, 01.04.2009, p. 703-706.

Research output: Contribution to journalArticle

Gourin, Christine G. ; Watts, Tammara ; Williams, Hadyn T. ; Patel, Vijay S. ; Bilodeau, Paul A. ; Coleman, Teresa A. / Identification of distant metastases with PET-CT in patients with suspected recurrent head and neck cancer. In: Laryngoscope. 2009 ; Vol. 119, No. 4. pp. 703-706.
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abstract = "Objectives: To investigate the utility of positron-emission tomography/computed tomography (PET-CT) in identifying distant metastatic disease in patients with suspected recurrent head and neck squamous cell cancer (HNSCC). Study Design: Retrospective analysis. Methods: Retrospective analysis of 64 consecutive patients with suspected recurrent HNSCC following definitive treatment who underwent PET-CT imaging were eligible for inclusion. Patients with previous known distant metastatic disease were excluded. Results: The majority of patients (81{\%}) had TNM stage III or IV disease. PET-CT was suspicious for pulmonary malignancy in 14 patients (22{\%}) and indeterminate in 6 patients (9{\%}). Pulmonary metastases or a new lung primary were present in 10 patients (16{\%}): 7 of 14 patients with positive PET-CT scans (50{\%}) and 3 of 50 patients with negative or indeterminate PET-CT scans (6{\%}). Including nonpulmonary sites, the overall incidence of distant disease was 23{\%} (15/64) with 20{\%} (13/64) unsuspected prior to PET-CT. The sensitivity and specificity of PET-CT in predicting distant malignancy was 86{\%} and 84{\%}, respectively, with a positive predictive value of 60{\%} and a negative predictive value of 95{\%}. There was a significant correlation between standardized uptake value (SUV) on PET-CT and positive histology, with a mean SUV of 8.5 (range, 4.7-16.2) in patients with distant metastases compared with a mean SUV of 2.9 (range, 1.9-4.2) in patients with benign pathology (r=0.87, P<.0001).",
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