The purpose of this study was to evaluate the role and timing of serial 18 F-FDG PET scans as routine surveillance for detecting early locoregional recurrence, distant metastases, and second primary tumors in patients treated for advanced squamous cell carcinoma (SCC) in the oral cavity or oropharynx during the first year after completion of their curative treatment. Methods: Forty-eight consecutive patients with SCC in the oral cavity or oropharynx were included after completing their initial therapy with curative intent. Prospective follow-up of the participants was 2-fold: regular follow-up (history and physical examination) and serial 18 F-FDG PET scans. Patients underwent standard follow-up and 18 F-FDG PET at 3, 6, 9, and 12 mo after initial treatment. Findings were validated by histopathology or 18 mo of clinical follow-up and imaging after initial treatment. Results: Incidence of recurrences and second primary tumors was 27% and 10%, respectively. 18 F-FDG PET was significantly (P 5 0.035) more often in agreement with the gold standard than was regular follow-up. 18 F-FDG PET showed a sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 43%, 51%, and 100%, respectively. For regular followup, these values were 0%, 60%, 0%, and 50%, respectively. 18 F-FDG PET accounted for a change in diagnostics or treatment in 63% of the patients and regular follow-up in 25% of the patients. Sensitivity and specificity of 18 F-FDG PET were both irrespective of timing of 18 F-FDG PET. For the 3-and 6-mo posttherapy results combined, 18 F-FDG PET detected malignancy in 16 of the 18 patients. Conclusion: 18 F-FDG PET is a suitable routine posttreatment surveillance tool in oral and oropharyngeal SCC patients and detects malignancy before clinical suggestion by the regular follow-up arises. The best timing of a systematic 18 F-FDG PET scan is between 3 and 6 mo after treatment.

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FDG PET in oral and oropharyngeal cancer. Value for confirmation of N0 neck and detection of occult metastases Krabbe, Christiaan A.; Dijkstra, Pieter U. ; Pruim, Jan; van der Laan, Bernard F.A.M.; van der Wal, Jacqueline E.; Gravendeel, Joost P.; Roodenburg, Johannes Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Summary Treatment of the clinical N0 neck in squamous cell carcinoma (SCC) of oral cavity and oropharynx remains a dilemma. None of the current imaging modalities are able to detect the presence of micrometastases in the lymph nodes of clinical N0 necks reliably. The aim of this study was to determine the diagnostic properties of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) in patients clinically staged as N0. FDG PET results of 38 patients were compared to histologic specimens obtained with neck dissections or to follow-up. FDG PET performance was compared to computed tomography (CT), magnetic resonance imaging (MRI) or ultrasonography-guided fine needle aspiration cytology (USgFNAC). Sensitivity and specificity of FDG PET in detecting occult cervical metastases were 50% and 97% respectively. Although FDG PET performed better than conventional imaging modalities, sensitivity was lower than desired. As a consequence, clinical application of FDG PET in the patient staged as N0 is limited.

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Because of bilateral accumulation of (11)C-TYR in salivary glands, (11)C-TYR PET is not suitable to replace (18)F-FDG PET in staging SCC of oral cavity and oropharynx.

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