F‐18‐fluoro‐deoxy‐glucose positron‐emission tomography scanning in detection of local recurrence after radiotherapy for laryngeal/ pharyngeal cancer

Abstract

When a local recurrence is suspected after radiotherapy for cancer of the larynx/pharynx, an FDG PET scan should be the first diagnostic step. No biopsy is needed if the scan is negative. If the scan is positive and the biopsy negative, a decreased FDG uptake measured in a follow-up scan indicates that a local recurrence is unlikely.

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

“…Residual occult neck metastases may be present in 30%-50% of patients with HNSCC who have advanced neck disease after completion of chemoradiotherapy [43][44][45][46].There remains significant controversy and variation in practice regarding optimal management of the neck [47]. A delay in the detection of residual HNSCC can have a negative impact on survival.…”

The diagnostic and prognostic utility of positron emission tomography/computed tomography‐based follow‐up after radiotherapy for head and neck cancer

“…Therefore, the specificity and false-positive rates should be considered critically in comparison with other studies that report only a single scan in a treated patient. 10,11,[24][25][26][27][28][29][30][31][32][33] In a recent meta-analysis of studies investigating the effectiveness of a single PET scan after RT that included patients with suspected disease recurrence, the sensitivity, specificity, positive predictive value, and negative predictive value were 94%, 82%, 75%, and 95%, respectively. 25 In our experience, false-positive findings in the head and neck remain an issue for PET or PET/CT in the followup care of patients with head and neck cancer.…”

“…[3][4][5] On the basis of previously published data suggesting that 18 F-fluorodeoxyglucose (FDG)-PET offers a more accurate assessment of therapy response and earlier detection of recurrent disease than conventional imaging, our group instituted a protocol incorporating PET/CT in the follow-up of patients with head and neck cancers in July, 2005. [6][7][8][9][10][11] The goals of this study were 1) to establish the diagnostic accuracy of follow-up PET/CT in the detection of locoregional recurrence, distant metastases, and second primary tumors; and 2) to determine the impact of PET/CT on the prognosis and management of suspected disease recurrence.…”

Detection of recurrent oral squamous cell carcinoma by [18F]‐2‐fluorodeoxyglucose‐positron emission tomography

“…It is, of course, possible that the tumor will recur at a later date, as [ 18 F]FDG-PET is capable of identifying small lesions invisible to morphologic imaging. 29 Still, a diagnostic dilemma is to discriminate between false-positive glucose metabolism and a true pathologic FDG uptake due to lesions not detected by other imaging modalities. We witnessed nine PET-positive sites of true tumor recurrence initially missed by a CT scan.…”