Clinical Significance of Postradiotherapy [{sup 18}F]-Fluorodeoxyglucose Positron Emission Tomography Imaging in Management of Head-and-Neck Cancer-A Long-Term Outcome Report

Journal Article · Fri May 01 04:00:00 EDT 2009 · International Journal of Radiation Oncology, Biology and Physics

OSTI ID:21276764

Smith, Russell B ^[1]; Hoffman, Henry T; Funk, Gerry F ^[2]; Minggen, Lu ^[3]; Menda, Yusuf; Graham, Michael M ^[4]; Buatti, John M ^[5]

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1. Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, Omaha, NE (United States)
2. Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, IA (United States)
3. University of Nevada at Reno School of Public Health, Reno, NV (United States)
4. Department of Radiology, University of Iowa, Iowa City, IA (United States)
5. Department of Radiation Oncology, University of Iowa, Iowa City, IA (United States)

Purpose: To determine the accuracy and prognostic significance of post-treatment [{sup 18}F]-fluorodeoxyglucose positron emission tomography (FDG-PET) in head-and-neck squamous cell carcinoma after radiotherapy (RT). Methods and Materials: This was a retrospective study of 188 patients with head-and-neck squamous cell carcinoma who had undergone FDG-PET within 12 months after completing RT. All living patients had {>=}1 year of follow-up after FDG-PET. All patients had undergone intensity-modulated RT, 128 with definitive and 60 with postoperative intensity-modulated RT. Results: For all patients, the median follow-up after RT completion was 32.6 months and after FDG-PET was 29.2 months. For the neck, 171 patients had negative FDG-PET findings. Of these results, two were falsely negative. Seventeen patients had positive FDG-PET findings, of which 12 were true-positive findings. The sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET in the assessment of the treatment response in the neck was 86%, 97%, 71%, and 99%, respectively. For the primary site, 151 patients had negative FDG-PET findings, of which two were falsely negative. Thirty-seven patients had positive FDG-PET findings, of which 12 were true-positive findings. The sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET in the assessment of the treatment response in the primary site was 86%, 86%, 32.4%, and 98.7%, respectively. Patients with positive post-RT PET findings had significantly worse 3-year overall survival and disease-free survival. Conclusion: The results of our study have shown that the findings of post-RT FDG-PET have a high negative predictive value and are a significant prognostic factor. It can provide guidance for the management of head-and-neck cancer after definitive treatment.

• OSTI ID: 21276764
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 74; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
FLUORINE 18
FLUORODEOXYGLUCOSE
HEAD
NECK
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
RADIOTHERAPY
SENSITIVITY
SPECIFICITY