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Positron emission tomography–CT prediction of occult nodal metastasis in recurrent laryngeal cancer
Author(s) -
Rosko Andrew,
Birkeland Andrew,
Shuman Andrew,
Prince Mark,
Bradford Carol,
Wolf Gregory,
Worden Francis,
Eisbruch Avraham,
Srinivasan Ashok,
Wong Ka Kit,
Spector Matthew E.
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24719
Subject(s) - medicine , positron emission tomography , laryngectomy , occult , radiology , neck dissection , metastasis , confidence interval , retrospective cohort study , nuclear medicine , cancer , larynx , surgery , pathology , alternative medicine
Background The purpose of this study was to evaluate the predictive value of positron emission tomography (PET)‐CT in identifying occult nodal metastasis in clinically and radiographically N0 patients with recurrent laryngeal cancer undergoing salvage laryngectomy. Methods Retrospective review of 46 clinically and radiographically N0 patients with recurrent laryngeal cancer who underwent a PET‐CT examination before salvage laryngectomy with neck dissection from January 1, 2002, to December 31, 2014, was performed. Results Two patients (16.7%) had true‐positive PET‐CT results, whereas 10 patients (83.3%) had false‐negative scans, 1 patient (2.9%) had a false‐positive result and 33 patients (97.1%) had a true‐negative PET‐CT. The sensitivity of PET‐CT was 16.7% (95% confidence interval [CI], 3.5% to 46.0%) with a specificity of 97.1% (95% CI, 83.8% to 99.9%), positive predictive value (PPV) of 66.7% (95% CI, 20.2% to 94.4%), and negative predictive value (NPV) of 76.7% (95% CI, 62.1% to 87.0%). Conclusion PET‐CT has poor sensitivity and NPV making PET‐CT an imperfect predictor of nodal disease in recurrent laryngeal cancer. © 2017 Wiley Periodicals, Inc. Head Neck 39: 980–987, 2017