Clinical Utility of<sup>18</sup>F-FDG PET/CT in Assessing the Neck After Concurrent Chemoradiotherapy for Locoregional Advanced Head and Neck Cancer

Ong, Seng Chuan; Schöder, Heiko; Lee, Nancy Y.; Patel, Snehal G.; Carlson, Diane L.; Fury, Matthew G.; Pfister, David G.; Shah, Jatin P.; Larson, Steven M.; Kraus, Dennis H.

doi:10.2967/jnumed.107.044792

Cited by 249 publications

(207 citation statements)

References 40 publications

Supporting

Mentioning

188

Contrasting

Unclassified

Order By: Relevance

“…At present, cross-sectional imaging is unequivocally important in the management of HNSCC [31,32], and it is widely recognized that CT and magnetic resonance imaging are associated with poor specificity in differentiating post-treatment edema or fibrosis from recurrent disease [33][34][35] . Metabolic functional changes in tissues usually precede morphological alterations.…”

Section: Discussionmentioning

confidence: 99%

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

Kostakoğlu¹,

Fardanesh²,

Posner

et al. 2013

The Oncologist

View full text Add to dashboard Cite

Objective. The objective of this study was to compare the efficacy of surveillance high-resolution computed tomography (HRCT) and physical examination/endoscopy (PE/E) with the efficacy of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/HRCT for the detection of relapse in head and neck squamous cell carcinoma (HNSCC) after primary treatment. Methods. This is a retrospective analysis of contemporaneously performed FDG-PET/HRCT, neck HRCT, and PE/E in 99 curatively treated patients with HNSCC during post-therapy surveillance to compare performance test characteristics in the detection of early recurrence or second primary cancer. Results. Relapse occurred in 19 of 99 patients (20%) during a median follow-up of 21 months (range: 9 -52 months). Median time to first PET/HRCT was 3.5 months. The median time to radiological recurrence was 6 months (range: 2.3-32 months). FDG-PET/ HRCT detected more disease recurrences or second primary cancers and did so earlier than HRCT or PE/E. The sensitivity, specificity,andpositiveandnegativepredictivevaluesfordetectinglocoregionalanddistantrecurrenceorsecondprimarycancer were 100%, 87.3%, 56.5%, and 100%, respectively, for PET/HRCT versus 61.5%, 94.9%, 66.7%, and 93.8%, respectively, for HRCT versus 23.1%, 98.7%, 75%, and 88.6%, respectively, for PE/E. In 19 patients with true positive PET/HRCT findings, a significant change in the management of disease occurred, prompting either salvage or systemic therapy. Of the 14 curatively treated patients, 11 were alive with without disease at a median follow-up of 31.5 months. Conclusion. FDG-PET/HRCT has a high sensitivity in the early detection of relapse or second primary cancer in patients with HNSCC, with significant management implications. Given improvements in therapy and changes in HNSCC biology, appropriate modifications in current post-therapy surveillance may be required to determine effective salvage or definitive therapies. The Oncologist 2013;18:1108 -1117 Implications for Practice: The role of PET/CT in the post-therapy surveillance of head and neck cancer is not defined by prospective studies, but cumulative retrospective data support the use of FDG-PET/CT in this setting. By corroborating prior results, we believe that we have an important message for physicians and health insurance carriers, that after completion of primary definitive treatment, surveillance PET/CT detects relapse earlier than both diagnostic CT and NCCN-recommended conventional methods. Although retrospectively, we report a significant change in disease management after PET/CT results suggested a survival benefit compared with reported historical data. We found that most patients had recurrence in the first 2 years after completion of therapy, and PET/CT detected most recurrences within the first 6-month period. Our findings corroborate those of other authors, and therefore, there is merit to recommending a post-therapy scan 3-4 months after completion of therapy, followed by another scan within the first year and scanning every 6 months ...

show abstract

Section: Discussionmentioning

confidence: 99%

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

Kostakoğlu¹,

Fardanesh²,

Posner

et al. 2013

The Oncologist

View full text Add to dashboard Cite

show abstract

“…The use of computed tomography (CT) scans has been reported to be convenient and helpful in the evaluation of nodal response in terms of accuracy (negative predictive value: 88.5-94%) [8,9]. Some authors have also advocated the use of post-treatment fludeoxyglucose [F18]-positron emission tomography (PET) in determining the presence or absence of residual neck disease [5][6][7]10]. Goenka et al…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, most patients with N2 or N3 disease have generally undergone initial ND consisting of upfront ND followed by concomitant chemoradiotherapy (CRT) or radiotherapy (RT), and planned ND regardless of nodal response [3,4]. However, in recent years, some investigators have advocated observation of the neck in patients initially diagnosed with N2-N3 disease, provided a complete response (CR) of regional disease is achieved after CRT or RT [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

The role of initial neck dissection for patients with node-positive oropharyngeal squamous cell carcinomas

et al. 2014

View full text Add to dashboard Cite

“…Changes in glucose metabolism are often evident before the appearance of a physical change or symptom, which is crucial for the adjustment of the therapeutic regimen. 18 F-FDG PET/CT displays a high sensitivity and a relatively high specificity in the evaluation of recurrent NPC and the response to treatment (9,10).…”

Section: Discussionmentioning

confidence: 99%

Clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in evaluating relapsed and refractory nasopharyngeal carcinoma: A case report

Zhao

Fang

et al. 2015

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. For patients with locoregionally advanced nasopharyngeal carcinoma (NPC), radiotherapy, chemotherapy and even targeted therapy are widely accepted treatments. These treatments, although they mostly achieve locoregional tumor control, they may also be associated with complex post-treatment changes, such as edema, loss of tissue planes, fibrosis, mucositis and scarring, which may interfere with the detection of local recurrence and the response to therapy. However, timely detection is crucial for deciding whether treatment modification or discontinuation is required. This is the case report of a 51-year-old nasopharyngeal carcinoma patient with cervical nodal metastases (CNM). Following radiotherapy, chemotherapy and targeted therapy, multislice spiral enhanced computed tomography (CT), enhanced magnetic resonance imaging (MRI) and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET)̸CT of the neck were performed to compare the extent of the CNM. The enhanced CT and MRI images were unremarkable, whereas the 18 F-FDG PET̸CT images revealed the exact recurrence or remission. Therefore, 18 F-FDG PET/CT exhibits a better sensitivity and specificity for evaluating the response to combined treatment compared to CT and/or MRI.

show abstract

Clinical Utility of¹⁸F-FDG PET/CT in Assessing the Neck After Concurrent Chemoradiotherapy for Locoregional Advanced Head and Neck Cancer

Cited by 249 publications

References 40 publications

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

The role of initial neck dissection for patients with node-positive oropharyngeal squamous cell carcinomas

Clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in evaluating relapsed and refractory nasopharyngeal carcinoma: A case report

Contact Info

Product

Resources

About

Clinical Utility of18F-FDG PET/CT in Assessing the Neck After Concurrent Chemoradiotherapy for Locoregional Advanced Head and Neck Cancer

Cited by 249 publications

References 40 publications

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

Early Detection of Recurrent Disease by FDG-PET/CT Leads to Management Changes in Patients With Squamous Cell Cancer of the Head and Neck

The role of initial neck dissection for patients with node-positive oropharyngeal squamous cell carcinomas

Clinical value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in evaluating relapsed and refractory nasopharyngeal carcinoma: A case report

Contact Info

Product

Resources

About

Clinical Utility of¹⁸F-FDG PET/CT in Assessing the Neck After Concurrent Chemoradiotherapy for Locoregional Advanced Head and Neck Cancer