PET‐CT in recurrent head neck cancers: A study to evaluate impact on patient management

Pantvaidya, Gouri; Agarwal, Jai Prakash; Deshpande, Mandar; Rangarajan, Venkatesh; Singh, Vikas; Kakade, Anagha; D’Cruz, Anil

doi:10.1002/jso.21257

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…This incremental benefit offered by PETCT is instrumental in clinical decision making and leads to change in management strategy. This has been highlighted by other authors too [6].…”

Section: Discussionmentioning

confidence: 74%

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PET Scan in Head and Neck Tumours in a Developing Country Like India: Is It a Must?

Kapre

Dabholkar²

2013

Indian J Otolaryngol Head Neck Surg

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To study the impact of Positron emission tomography (PET) and its incremental value in diagnosing an unknown primary tumour with secondaries in the head and neck; recurrent head and neck cancers (confirmation of suspected recurrences and re-staging); and staging of head and neck tumours. This was a prospective observational study where 60 patients of head and neck tumours under the clinical settings as described above were evaluated. Thorough clinical examination and necessary radiological and histopathological investigations were done. All patients underwent a PET scan, the results of which were correlated with histopathological examination. Sensitivities, specificities, positive and negative predictive values, false positives and false negatives of PET scan in the different indications were calculated. The study included 11 patients of unknown primary, 28 patients with suspected recurrent tumours and 21 patients where PET scan was done for initial staging. PETCT scan was able to detect the primary in 3 out of 11 patients (27.27 %) who presented with cervical metastases with an unknown primary. In 2 of the 8 patients where a primary tumour was not found, PETCT detected distant metastases. For recurrent tumours, PETCT scan showed sensitivity, specificity, positive predictive value and negative predictive value as 100, 72.72, 85 and 100 % respectively. In restaging of recurrent disease, 4 out of 28 patients were detected to have distant metastases. In 7 cases of locoregionally advanced tumors, where PETCT scan was used for pre-treatment staging, it detected distant metastases in 4 of 7 patients. In the patients with N0 neck status PETCT scan showed a sensitivity, specificity, positive predictive value and negative predictive value of 100, 66.67, 50 and 100 % respectively. PETCT scan was able to alter the plan of management in 15 out of 60 patients. Thus, in carefully selected patients PETCT scan can provide incremental information that proves invaluable in these circumstances even in a developing country like India. In all the settings, PETCT scan demonstrated a very high negative predictive value. Hence, negative PETCT scan could be interpreted as absence of disease with reasonable assurance.

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“…This incremental benefit offered by PETCT is instrumental in clinical decision making and leads to change in management strategy. This has been highlighted by other authors too [6].…”

Section: Discussionmentioning

confidence: 74%

“…This unique quality confers on PETCT scan the utility of providing crucial information over and above routine examination and investigations. It has therefore shown to alter and guide the management plan in patients of head and neck malignancies [6].…”

Section: Discussionmentioning

confidence: 99%

PET Scan in Head and Neck Tumours in a Developing Country Like India: Is It a Must?

Kapre

Dabholkar²

2013

Indian J Otolaryngol Head Neck Surg

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“…In contrast, MRI can be more useful in diagnosing soft tissue metastases and differentiating metastatic disease from sarcomas and other processes [18,19]. In a recent study on imaging modalities for recurrent head and neck cancers, addition of PET/CT to traditional imaging modalities was found to significantly change the clinical management in 38.7% of patients [20]. The sensitivity and specificity of PET/CT for distant metastatic disease was 100% and 88.89% respectively [20].…”

Section: Discussionmentioning

confidence: 99%

“…In a recent study on imaging modalities for recurrent head and neck cancers, addition of PET/CT to traditional imaging modalities was found to significantly change the clinical management in 38.7% of patients [20]. The sensitivity and specificity of PET/CT for distant metastatic disease was 100% and 88.89% respectively [20]. Our patient received a PET/CT which demonstrated significant uptake only at the site of the abdominal wall mass, without any other identifiable lesions or lymphadenopathy.…”

Section: Discussionmentioning

confidence: 99%

Isolated skeletal muscle metastasis following successful treatment of laryngeal cancer: case report

Klune

Zuckerbraun

Tsung

2010

Int Semin Surg Oncol

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Skeletal muscle metastases from tumors are a rare occurrence and can present difficult management decisions. We report here on a patient that had been previously treated for squamous cell laryngeal cancer with surgical resection and adjuvant systemic chemotherapy that presented with a metastasis to the rectus abdominis muscle without evidence of recurrent disease at the primary site. After a metastatic workup with PET/CT scan suggested this to be an isolated lesion, surgical excision with negative margins was performed based upon limited treatment options secondary to the location of the tumor and his favorable prognosis suggested by his pathological staging at the time of the initial resection. Here we discuss the incidence of distant metastases from laryngeal cancer and appropriate screening methods. Additionally, skeletal muscle metastases and treatment considerations are discussed.

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“…7 However, false-positive results in the area of the tonsils, base of the tongue, and oral tongue 8 are not uncommon. In one series, treatment was changed in 38.7% of patients with recurrent head and neck cancer following PET/CT; 16.3% underwent major changes in therapy.…”

mentioning

confidence: 99%

Indications for Adjuvant Chemotherapy and Radiation Therapy

Ord¹

2012

Current Therapy in Oral and Maxillofacial Surgery

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PET‐CT in recurrent head neck cancers: A study to evaluate impact on patient management

Abstract: In our study, PET-CT had a significant impact on the management of patients with suspected recurrent head neck cancer.

Cited by 9 publications

References 11 publications

PET Scan in Head and Neck Tumours in a Developing Country Like India: Is It a Must?

PET Scan in Head and Neck Tumours in a Developing Country Like India: Is It a Must?

Isolated skeletal muscle metastasis following successful treatment of laryngeal cancer: case report

Indications for Adjuvant Chemotherapy and Radiation Therapy

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