Follow-up in patients with head and neck tumors: evaluation of CT criteriafor local tumor recurrence.

Background: Aim of this study was to evaluate morphologic criteria for diag nosis of locally recurrent head and neck tumors in helical CT. Methods: Ret rospective study, 44 examinations with radiologically abnormal findings wer e re-read by two radiologists; findings were analysed and correlated with h istological diagnosis and clinical findings. Results: 25 cases of local tum or recurrence were confirmed histologically. The accuracy of helical-CT in our preselected examinations for a local tumor recurrence was 93.5%, the sp ecificity 83.3%. But 13/44 cases showed radiologically equivocal findings, among them 6 tumor recurrences. The most common characteristics of the 25 p roven tumor recurrences were: contrast medium enhancement (96%), increased volume in comparison to previous examination (92%), inhomogenity (72%); how ever contrast medium-enhancement and increasing volume were also seen in 68 .4% and 63.1% of the benign changes. Conclusion: Contrast medium enhancemen t and increasing volume are criteria with a high sensitivity but low specif icity in predicting a local tumor recurrence in head and neck cancer.