Ch. Terhaard et al., F-18-fluoro-deoxy-glucose positron-emission tomography scanning in detection of local recurrence after radiotherapy for laryngeal/pharyngeal cancer, HEAD NECK, 23(11), 2001, pp. 933-941
Citations number
42
Categorie Soggetti
Otolaryngology
Journal title
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
Background, The objective of this investigation was to determine whether F1
8-fluoro-deoxy-glucose (FDG) positron-emission tomography (PET) could diffe
rentiate between local recurrence and late radiation effects after radiothe
rapy for laryngeal/pharyngeal cancer.
Methods. In a prospective study of 75 patients (67 larynx, eight oro/hypoph
arynx), 160 laryngoscopies and 109 FDG PET scans were performed on the head
and neck region. The mean follow-up time after the first FDG PET scan was
23 months (minimum 1 year).
Results. Local recurrence was diagnosed in 37 patients: 19 after the first
biopsy and 18 after follow-up biopsies. For all of the negative initial FDG
scans (27), the biopsies that were taken at the same time were negative an
d no recurrence was seen for at least I year. The first FDG scan was a true
positive in 34 of 48 patients, In 12 of the 14 patients with false-positiv
e results, FDG scans were repeated; a decreased FDG uptake was found in 9 o
f the 12. The sensitivity and specificity of the first scan were respective
ly 92% and 63% including subsequent FDG scans, the rates were 97% and 82%,
respectively.
Conclusions. When a local recurrence is suspected after radiotherapy for ca
ncer of the larynx/pharynx, an FDG PET scan should be the first diagnostic
step. No biopsy is needed if the scan is negative. If the scan Is positive
and the biopsy negative, a decreased FDG uptake measured in a follow-up sca
n indicates that a local recurrence is unlikely. (C) 2001 John Wiley & Sons
, Inc.