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Positron emission tomography–computed tomography surveillance for the node‐positive neck after chemoradiotherapy
Author(s) -
Rabalais Amy G.,
Walvekar Rohan,
Nuss Daniel,
McWhorter Andrew,
Wood Charles,
Fields Robert,
Mercante Donald E.,
Pou Anna M.
Publication year - 2009
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.20201
Subject(s) - medicine , positron emission tomography , radiology , head and neck squamous cell carcinoma , nuclear medicine , chemoradiotherapy , head and neck cancer , positron emission , positron emission tomography computed tomography , pet ct , neck dissection , tomography , computed tomography , retrospective cohort study , carcinoma , radiation therapy , surgery
Abstract Objectives/Hypothesis: To review our results with positron emission tomography and computed tomography fusion imaging (PET‐CT) surveillance of the postchemoradiotherapy neck in patients with advanced head and neck squamous cell carcinoma. Study Design: Retrospective. Methods: Four hundred twenty‐eight patients with advanced head and neck squamous cell carcinoma were treated with nonsurgical therapy from September 2002 to March 2007 and followed with post‐treatment PET‐CT surveillance of the neck. Fifty‐two patients meeting inclusion criteria were analyzed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET‐CT were determined. Results: Ten patients had a positive post‐treatment PET‐CT for residual neck disease, and 42 patients had negative scans. The NPV and PPV were 100% and 40%, respectively. The sensitivity, specificity, and accuracy were 100%, 87.5%, and 88%, respectively. Conclusions: Planned neck dissection can be deferred with a negative post‐treatment PET‐CT. Assuming a complete response at the primary site and a negative PET‐CT scan, there may be a role for serial PET‐CT surveillance in patients with residual palpable cervical lymphadenopathy. Laryngoscope, 2009