Head and neck cancer: Clinical usefulness and accuracy of PET/CT image fusion Journal Article
| Authors: | Schöder, H.; Yeung, H. W. D.; Gonen, M.; Kraus, D.; Larson, S. M. |
| Article Title: | Head and neck cancer: Clinical usefulness and accuracy of PET/CT image fusion |
| Abstract: | PURPOSE: To compare diagnostic accuracy of attenuation-corrected positron emission tomography (PET) with fused PET and computed tomography (CT) in patients with head and neck cancer and to evaluate the effect of PET/CT findings on patient care. MATERIALS AND METHODS: Studies of 68 patients were reviewed by two physicians in consensus. Focal fluorodeoxyglucose (FDG) uptake in the head and neck on attenuation-corrected PET images was graded as benign, equivocal, or malignant. CT and PET/CT images were then reviewed, and initial findings were amended if necessary. Comparison was performed on a lesion-by-lesion basis. Accuracy was evaluated on the basis of follow-up and histopathologic findings. Potential effects on patient care were assessed by a head and neck surgeon. PET and PET/CT accuracy was compared with a McNemar test adjusted for clustering. RESULTS: A total of 157 foci with abnormal FDG uptake were noted, two of which were seen only on PET/CT images. PET/CT images were essential in determining the exact anatomic location for 100 lesions (74% better localization in regions previously treated surgically or with irradiation vs 58% in untreated areas; P = .06). On the basis of PET findings alone, 45 lesions were considered benign; 39, equivocal; and 71, malignant. With PET/CT, the fraction of equivocal lesions decreased by 53%, from 39 of 155 to 18 of 157 (P < .01). PET/CT had a higher accuracy of depicting cancer than did PET (96% vs 90%, P = .03). Six proved malignancies were missed with PET, but only one was missed with PET/CT. PET/CT findings altered the care for 12 (18%) of 68 patients. CONCLUSION: PET/CT is more accurate than PET alone in the detection and anatomic localization of head and neck cancer and has the clear potential to affect patient care. © RSNA, 2004. |
| Keywords: | adolescent; adult; cancer chemotherapy; human tissue; aged; aged, 80 and over; middle aged; cancer surgery; retrospective studies; major clinical study; histopathology; cancer localization; carcinoma, squamous cell; cancer radiotherapy; cancer staging; positron emission tomography; follow up; follow-up studies; antineoplastic agent; lymph nodes; diagnostic accuracy; sensitivity and specificity; radiopharmaceuticals; computer assisted tomography; image analysis; image interpretation, computer-assisted; tomography, x-ray computed; diagnostic imaging; retrospective study; imaging system; patient care; evaluation; head and neck cancer; head and neck neoplasms; contrast enhancement; fluorodeoxyglucose f18; reliability; parameter; false positive reactions; fluorodeoxyglucose; bioaccumulation; positron emission tomography (pet); tomography, emission-computed; muscle, skeletal; computed tomography (ct); humans; human; male; female; priority journal; article; mcnemar test; dual-modality imaging, pet/ct; images, fusion |
| Journal Title: | Radiology |
| Volume: | 231 |
| Issue: | 1 |
| ISSN: | 0033-8419 |
| Publisher: | Radiological Society of North America, Inc. |
| Date Published: | 2004-04-01 |
| Start Page: | 65 |
| End Page: | 72 |
| Language: | English |
| DOI: | 10.1148/radiol.2311030271 |
| PROVIDER: | scopus |
| PUBMED: | 14990824 |
| DOI/URL: | |
| Notes: | Radiology -- Cited By (since 1996):269 -- Export Date: 16 June 2014 -- CODEN: RADLA -- Source: Scopus |
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