Correlation of fine needle aspiration biopsy and fluoride-18 fluorodeoxyglucose positron emission tomography in the assessment of locally recurrent and metastatic head and neck neoplasia

OBJECTIVE: Patients with primary head and neck neoplasia can present during follow-up with suspected recurrence, and both fine needle aspiration biops y (FNAB) and fluoride-18 fluorodeoxyglucose positron emission tomography (F DG-PET) scan are available methodologies for evaluating these patients. Our objective was to retrospectively correlate patients who underwent both FNA B and FDG-PET scan in order to assess the possibility of recurrent neoplasi a. STUDY DESIGN: The cytopathology files at Saint Louis University Health Scie nces Center were retrospectively searched for patients with known primary h ead and neck malignancies beginning in 1995. Suspected recurrence and local metastases evaluated by both FNAB and FDG-PET scan were correlated. RESULTS: Twenty-eight patients received a combined total of 37 FNABs with c oncurrent FDG-PET scans. The majority of patients had primary oropharyngeal squamous cell carcinoma with intermixed, single cases of other primary hea d and neck neoplasms. Thirty of the 32 aspirates with recurrent or locally metastatic disease had combined positive findings by both FNAB and FDG-PET scan, yielding a sensitivity of 94%. One nonspecific and one negative FDG-P ET scan came from a patient who had disease confirmed by FNAB. Five patient s had negative findings by both methods that were supported by the subseque nt clinical course. CONCLUSION: FNAB can provide confirmatory evidence of disease in a clinical ly suspicious abnormality with nonspecific FDG-PET results. FNAB and FDG-PE T are highly sensitive for tumors in cases of clinically sustpected recurre nce and locally metastatic disease.