Open AccessPreoperative 18 F‐FDG‐PET/CT vs Contrast‐Enhanced CT to Identify Regional Nodal Metastasis among Patients with Head and Neck Squamous Cell Carcinoma
Author(s) -
Cho Joshua K.,
Ow Thomas J.,
Lee Andrew Y.,
Smith Richard V.,
Schlecht Nicolas F.,
Schiff Bradley A.,
Tassler Andrew B.,
Lin Juan,
Moadel Renee M.,
Valdivia Ana,
Abraham Tony,
Gulko Edwin,
Neimark Matthew,
Ustun Berrin,
Bello Jacqueline A.,
Shifteh Keivan
Publication year - 2017
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599817703927
Subject(s) - medicine , concordance , radiology , stage (stratigraphy) , positron emission tomography , nuclear medicine , neck dissection , histopathology , head and neck squamous cell carcinoma , head and neck , t stage , dissection (medical) , metastasis , radiation therapy , carcinoma , head and neck cancer , cancer , pathology , surgery , paleontology , biology
Objective Our objective was to compare the accuracy of preoperative positron emission tomography (PET)/computed tomography (CT) and contrast‐enhanced CT (CECT) in detecting cervical nodal metastases in patients treated with neck dissection and to scrutinize the ability of each modality to determine nodal stage. Study Design Case series with chart review. Setting Montefiore Medical Center, Bronx, New York. Subjects and Methods Patients who underwent neck dissection at our institution for primary treatment of head and neck squamous cell carcinoma (HNSCC) and had received preoperative PET/CT and CECT were included in this study. Imaging studies were reinterpreted by 3 specialists within the field and compared for interreader agreement. Concordance between radiology and histopathology was measured using neck levels and sides, along with patient nodal stage. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and agreement coefficients were calculated. Results Seventy‐three patients were included in the study. Sensitivity was 0.69 and 0.94 (level and side) for PET/CT vs 0.53 and 0.66 for CECT ( P =. 056, P =. 001). Specificity was 0.86 and 0.56 for PET/CT vs 0.91 and 0.76 for CECT ( P =. 014, P =. 024). No significant difference was found in overall accuracy ( P =. 33, P =. 88). The overall agreement percentages between N stage called by imaging modality and pathology were 52% and 55% for PET/CT and CECT, respectively. Conclusion No significant difference in sensitivity was found between PET/CT and CECT. CECT was found to have superior specificity compared with PET/CT. The information gleaned from each modality in the pretreatment evaluation of HNSCC appears to be complementary.