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

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

doi:10.1002/lary.20118

Cited by 38 publications

(33 citation statements)

References 19 publications

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“…Fifth, the sensitivities in the HSROC curves for the included studies were not uniformly high. Nine (22%) of the 41 included studies had sensitivities of less than 75% (5,10,11,13,19,21,24,25,32). No clear reason for the large difference between these studies and other studies was found.…”

Section: Discussionmentioning

confidence: 81%

“…Head and Neck Cancer. When we considered all 16 studies (1,800 patients) with data on head and neck cancer (1,(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), the pooled sensitivity, specificity, PLR, and NLR of 18 Lung Cancer. When we considered all 5 studies (578 patients) with data on lung cancer (22)(23)(24)(25)(26), the pooled sensitivity, specificity, PLR, and NLR of 18 Breast Cancer.…”

Section: Quality Assessmentmentioning

confidence: 99%

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Performance of Whole-Body PET/CT for the Detection of Distant Malignancies in Various Cancers: A Systematic Review and Meta-Analysis

Zhao

Zhou

2012

J Nucl Med

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At present, there is no ideal imaging modality for the diagnosis of distant metastases and second primary cancers in cancer patients. We aimed to assess the accuracy of whole-body PET/CT for the overall assessment of distant malignancies in patients with various cancers. Methods: Studies about wholebody PET/CT for the detection of distant malignancies in cancer patients were systematically searched in MEDLINE and EMBASE. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios, and constructed summary receiver operating characteristic curves using hierarchical regression models for whole-body PET/CT. Results: Across 41 studies (4,305 patients), the sensitivity and specificity of whole-body PET/CT were 0. The presence of distant metastases is one of the most important prognostic factors in most cancer patients. Most tumors are classified according to the TNM staging system, and treatment is modified when distant metastases are present. Disease localized to primary sites and to regional lymph nodes is generally treated with curative strategies, including surgery, chemotherapy, and radiotherapy. In contrast, palliative treatment of patients with metastatic disease consists of less aggressive strategies. Moreover, distant metastases usually occur late during the course of cancer, whereas second primary cancers may be found even in early-stage patients. Early detection of distant metastases and second primary cancers is a fundamental precondition for guiding precise staging and optimal management.Conventional imaging procedures (such as chest radiography, CT, abdominal ultrasonography, and bone scan) are commonly used to detect distant metastases and second primary cancers in patients with various cancers (1,2). However, conventional imaging procedures often do not reliably characterize the extent of disease because it is difficult to identify small distant lesions on the basis of morphologic criteria and to distinguish potential metastatic lesions from benign findings. 18 F-FDG PET is a functional imaging modality that is based on the increased glucose metabolism of malignant cells. However, anatomic information concerning distant lesions is limited on 18 F-FDG PET images, and the resolution is insufficient to detect small lesions. The introduction of PET/CT scanners combined the functional data of PET with the detailed anatomic information of CT into a single examination. In several previous studies, 18 F-FDG PET/CT was shown to be more sensitive and specific than conventional imaging procedures for the detection of distant malignancies in cancer patients at initial staging before treatment or restaging after treatment (1-5). Although many studies about wholebody PET/CT for various cancers were done, the results were still controversial and inconclusive. Here, we undertook a meta-analysis to evaluate the diagnostic performance of whole-body PET/CT for detecting distant malignancies in patients with various cancers. MATERIALS AND METHODS Search StrategyWe searc...

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Section: Discussionmentioning

confidence: 81%

Section: Quality Assessmentmentioning

confidence: 99%

Performance of Whole-Body PET/CT for the Detection of Distant Malignancies in Various Cancers: A Systematic Review and Meta-Analysis

Zhao

Zhou

2012

J Nucl Med

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“…The use of pre-treatment FDG-PET/CT is advocated by many centers 11–13. FDG-PET/CT has been shown to effectively diagnose second primary tumors and distant metastasis in HNSCC patients 12–16.…”

Section: Discussionmentioning

confidence: 99%

FDG-PET/CT in the Assessment of Treatment Response after Oncologic Treatment of Head and Neck Squamous Cell Carcinoma

Keski-Säntti

Mustonen

Schildt

et al. 2014

Clin Med Insights Ear Nose Throat

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BACKGROUNDIn many centers, 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) is used to monitor treatment response after definitive (chemo)radiotherapy [(C)RT] for head and neck squamous cell carcinoma (HNSCC), but its usefulness remains somewhat controversial. We aimed at assessing the accuracy of FDG-PET/CT in detecting residual disease after (C)RT.METHODAll HNSCC patients with FDG-PET/CT performed to assess treatment response 10–18 weeks after definitive (C)RT at our institution during 2008–2010 were included. The patient charts were reviewed for FDG-PET/CT findings, histopathologic findings, and follow-up data. The median follow-up time for FDG-PET/CT negative patients was 26 months.RESULTSEighty-eight eligible patients were identified. The stage distribution was as follows: I, n = 1; II, n = 15; III, n = 17; IV, n = 55. The negative predictive value, positive predictive value, specificity, sensitivity, and accuracy of FDG-PET/CT in detecting residual disease were 87%, 81%, 94%, 65%, and 85%, respectively. The corresponding specific figures for the primary tumor site were 91%, 71%, 94%, 59%, and 86% and for the neck 93%, 100%, 100%, 75%, and 94%, respectively.CONCLUSIONSIn patients who have received definitive (C)RT for HNSCC, post-treatment FDG-PET/CT has good potential to guide clinical decision-making. Patients with negative scan can safely be followed up clinically only, while positive scan necessitates tissue biopsies or a neck dissection to rule out residual disease.

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“…The integration of PET and CT will provide more anatomic details for the PET images, which is considered the most valuable imaging modality for the overall assessment of distant metastasis in patients with HNSCC (sensitivity: 88.8%; specificity: 95.1%) . Although many PET‐CT studies have been done, there has been no consensus with regard to the role of 18 FDG PET‐CT for diagnosis of lung malignancies in patients with HNSCC . Therefore, a meta‐analysis aiming to evaluate the diagnostic value of 18 FDG PET‐CT is urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of¹⁸fluorodeoxyglucose positron emission tomography-CT for diagnosis of lung malignancies in patients with head and neck squamous cell carcinomas

Xie

2014

Head Neck

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

Cited by 38 publications

References 19 publications

Performance of Whole-Body PET/CT for the Detection of Distant Malignancies in Various Cancers: A Systematic Review and Meta-Analysis

Performance of Whole-Body PET/CT for the Detection of Distant Malignancies in Various Cancers: A Systematic Review and Meta-Analysis

FDG-PET/CT in the Assessment of Treatment Response after Oncologic Treatment of Head and Neck Squamous Cell Carcinoma

Meta-analysis of¹⁸fluorodeoxyglucose positron emission tomography-CT for diagnosis of lung malignancies in patients with head and neck squamous cell carcinomas

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

Cited by 38 publications

References 19 publications

Performance of Whole-Body PET/CT for the Detection of Distant Malignancies in Various Cancers: A Systematic Review and Meta-Analysis

Performance of Whole-Body PET/CT for the Detection of Distant Malignancies in Various Cancers: A Systematic Review and Meta-Analysis

FDG-PET/CT in the Assessment of Treatment Response after Oncologic Treatment of Head and Neck Squamous Cell Carcinoma

Meta-analysis of18fluorodeoxyglucose positron emission tomography-CT for diagnosis of lung malignancies in patients with head and neck squamous cell carcinomas

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Meta-analysis of¹⁸fluorodeoxyglucose positron emission tomography-CT for diagnosis of lung malignancies in patients with head and neck squamous cell carcinomas