Ga-67 whole-body scintigraphy in the evaluation of head and neck squamous cell carcinoma

The diagnostic accuracy of Ga-67-citrate whole-body scintigraphy for the ev aluation of primary rumours, local recurrences, cervical node metastases an d distant metastases was investigated in patients with head and neck squamo us cell carcinoma (SCC). Altogether, 102 Ga-67-citrate whole-body scans wer e performed on 83 patients with head and neck SCC using a dual-headed gamma camera. The results were compared with those of computed tomography (CT) a nd final diagnosis. Ga-67 scintigraphy correctly diagnosed 28 of 29 primary lesions, a sensitivity of 97% (CT = 97%). For tumour recurrence, Ga-67 sci ntigraphy correctly diagnosed 13 of 15 recurrences and 53 of 58 instances o f no recurrence, giving a sensitivity of 87% and a specificity of 91% (CT = 80 and 62%, respectively). Scintigraphy correctly diagnosed 23 of 31 metas tatic sides of the neck and all 173 negative sides of the neck, giving a se nsitivity of 74% and a specificity of 100% (CT = 90 and 84%, respectively). Finally, scintigraphy correctly diagnosed all 12 distant metastases as wel l as 86 of 90 cases of no metastasis, resulting in a sensitivity of 100% an d a specificity of 96%. Furthermore, in five patients, distant metastases w ere initially detected on Ga-67 scintigraphy. In conclusion, Ga-67 whole-bo dy scintigraphy with a dual-headed camera resulted in a high sensitivity an d specificity for the detection of primary lesions, recurrences and distant metastases of head and neck SCC. Although the sensitivity for detecting ne ck node metastases was relatively low, the specificity was high. Thus, Ga-6 7 scintigraphy is an effective technique for the evaluation of head and nec k SCC, especially tumour recurrence and distant metastases. ((C) 1999 Lippi ncott Williams & Wilkins).