RECURRENCE OF HEAD AND NECK-CANCER AFTER SURGERY OR IRRADIATION - PROSPECTIVE COMPARISON OF 2-DEOXY-2-[F-18]FLUORO-D-GLUCOSE PET AND MR-IMAGING DIAGNOSES

PURPOSE: To evaluate the diagnostic accuracy of positron emission tomo graphy (PET) with administration of 2-deoxy-2-[fluorine-18]fluoro-D-gl ucose (FDG) relative to that of magnetic resonance (MR) imaging and/or computed tomography (CT) in recurrent head and neck cancers. MATERIAL S AND METHODS: Twelve adult patients (mean age, 63 years) with previou sly treated head and neck cancers and clinical suspicion of recurrence underwent FDG PET and MR imaging and/or CT. All images were blindly a nd independently interpreted without histopathologic findings (obtaine d within 1 week of imaging). The level of confidence in image interpre tation was graded by using a five-point rating system (0 = definitely no recurrence to 4 = definite recurrence). RESULTS: Recurrence was con firmed in eight patients. With a rating of 4 as a positive finding, FD G PET yielded a sensitivity and specificity of 88% (seven of eight) an d 100% (four of four), respectively; MR imaging and/or CT, 25% (two of eight) and 75% (three of four), respectively. Receiver-operating char acteristic analysis showed significantly better diagnostic accuracy wi th FDG PET than with MR imaging and/or CT (area under curve = 0.96 vs 0.55, P < .03). CONCLUSION: These data indicate that PET metabolic ima ging as compared with anatomic methods, has improved diagnostic accura cy for recurrent head and neck cancer.