Diagnostic and prognostic value of [18F]fluorodeoxyglucose positron emission tomography for recurrent head and neck squamous cell carcinoma Journal Article

Authors: Wong, R. J.; Lin, D. T.; Schöder, H.; Patel, S. G.; Gonen, M.; Wolden, S.; Pfister, D. G.; Shah, J. P.; Larson, S. M.; Kraus, D. H.
Article Title: Diagnostic and prognostic value of [18F]fluorodeoxyglucose positron emission tomography for recurrent head and neck squamous cell carcinoma
Abstract: Purpose: Patients with recurrent head and neck squamous cell carcinoma (HNSCC) present a diagnostic and therapeutic challenge. We evaluated the diagnostic accuracy and prognostic value of [18F]fluorodeoxyglucose positron emission tomography (PET) in this patient population. Patients and Methods: We performed a retrospective review of 143 patients with previously treated HNSCC who underwent 181 PET scans at our institution from May 1996 through April 2001 to detect recurrent disease. Disease recurrence within 6 months was used as the gold standard for assessing true disease status at PET. Results: With equivocal sites considered positive, the sensitivity and specificity of PET for detecting recurrence overall were 96% and 72%, respectively. PET was highly sensitive and specific at regional and distant sites. At local sites, sensitivity was high, but specificity was lower because of false-positive findings. One fifth of all false-positive PET scans occurred at sites of known inflammation or infection. The area under the curve for a receiver operator characteristic curve on the basis of standardized uptake value (SUV) was 0.882 ± 0.025. PET interpretation, SUV, and physical examination were independent predictors of relapse-free and overall survival in a time-dependent, multivariate proportional hazards model. An increase in SUV by one unit increased the relative risk (RR) of relapse by 11% and the RR of death by 14%. A positive PET interpretation increased the RR of relapse by four-fold and the RR of death by seven-fold. Conclusion: PET was a highly sensitive method of detecting recurrent HNSCC and provided important prognostic information for relapse-free and overall survival. © 2002 by American Society of Clinical Oncology.
Keywords: adolescent; adult; cancer survival; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; area under the curve; positron emission tomography; recurrent cancer; diagnostic accuracy; sensitivity and specificity; radiopharmaceuticals; neoplasm recurrence, local; proportional hazards models; retrospective study; diagnostic value; head and neck neoplasms; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; predictive value of tests; head and neck carcinoma; tomography, emission-computed; humans; prognosis; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 20
Issue: 20
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2002-10-15
Start Page: 4199
End Page: 4208
Language: English
DOI: 10.1200/jco.2002.02.590
PUBMED: 12377963
PROVIDER: scopus
Notes: Export Date: 14 November 2014 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Dennis Kraus
    258 Kraus
  2. Suzanne L Wolden
    419 Wolden
  3. Snehal G Patel
    286 Patel
  4. Mithat Gonen
    701 Gonen
  5. Derrick T Lin
    7 Lin
  6. Heiko Schoder
    285 Schoder
  7. David G Pfister
    247 Pfister
  8. Richard J Wong
    228 Wong
  9. Steven M Larson
    766 Larson
  10. Jatin P Shah
    538 Shah