TY - JOUR

T1 - FDG-PET/CT in the surveillance of head and neck cancer following radiotherapy

AU - Risor, Louise Madeleine

AU - Loft, Annika

AU - Berthelsen, Anne Kiil

AU - Loft, Frederik Cornelius

AU - Madsen, Andreas Ruhvald

AU - Vogelius, Ivan Richter

AU - Kjaer, Andreas

AU - Friborg, Jeppe

PY - 2020

Y1 - 2020

N2 - PurposeTo examine the time-dependent diagnostic performance of FDG-PET/CT in the follow-up of head and neck cancer (HNC) and to assess the prognostic value of PET-negative and PET-inconclusive findings.Material and methods279 HNC patients primarily treated with radiotherapy from 2006 to 2012 were included. The follow-up PET/CT scans were categorized as benign, malignant or inconclusive by a radiologist and a nuclear physician. The reference standard was histology or verification by progression on imaging. The outcome measures were positive (PPV) and negative predictive value (NPV), and the PET/CT scans were grouped according to time since treatment and compared. An analysis of the diagnostic accuracy was performed with the inconclusive results categorized as both benign and malignant to create ranges for the diagnostic performance.ResultsThe proportion of inconclusive results declined from 26 to 8.4% and 0% after 0–3, 3–6 and 12–24 months post-treatment. The ranges for diagnostic performance after 0–3, 3–6, 6–12, 12–24 months and overall post-treatment were: PPV 27.3–50, 48.4–58.3, 71.4–100, 100 and 50.5–65.7 and NPV 75.0–84.6, 95.1–96.8, 92.9–100, 100 and 94.8–96.7. Time to recurrence was not statistically different after a PET-negative or a PET-inconclusive result.ConclusionThe diagnostic accuracy of a surveillance PET/CT scan after HNC improves with time since treatment, and is very reliable after 1 year. However, the NPV is already high 3 months post-treatment supporting the use of PET/CT for early evaluation of head and neck cancer patients.

AB - PurposeTo examine the time-dependent diagnostic performance of FDG-PET/CT in the follow-up of head and neck cancer (HNC) and to assess the prognostic value of PET-negative and PET-inconclusive findings.Material and methods279 HNC patients primarily treated with radiotherapy from 2006 to 2012 were included. The follow-up PET/CT scans were categorized as benign, malignant or inconclusive by a radiologist and a nuclear physician. The reference standard was histology or verification by progression on imaging. The outcome measures were positive (PPV) and negative predictive value (NPV), and the PET/CT scans were grouped according to time since treatment and compared. An analysis of the diagnostic accuracy was performed with the inconclusive results categorized as both benign and malignant to create ranges for the diagnostic performance.ResultsThe proportion of inconclusive results declined from 26 to 8.4% and 0% after 0–3, 3–6 and 12–24 months post-treatment. The ranges for diagnostic performance after 0–3, 3–6, 6–12, 12–24 months and overall post-treatment were: PPV 27.3–50, 48.4–58.3, 71.4–100, 100 and 50.5–65.7 and NPV 75.0–84.6, 95.1–96.8, 92.9–100, 100 and 94.8–96.7. Time to recurrence was not statistically different after a PET-negative or a PET-inconclusive result.ConclusionThe diagnostic accuracy of a surveillance PET/CT scan after HNC improves with time since treatment, and is very reliable after 1 year. However, the NPV is already high 3 months post-treatment supporting the use of PET/CT for early evaluation of head and neck cancer patients.

KW - Head and neck cancer

KW - Surveillance

KW - Oncology

KW - Follow-up

KW - FDG-PET

KW - CT

KW - Radiotherapy

KW - Nuclear medicine

U2 - 10.1007/s00405-019-05684-2

DO - 10.1007/s00405-019-05684-2

M3 - Journal article

C2 - 31646385

VL - 277

SP - 539

EP - 547

JO - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde

JF - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde

SN - 0942-8992

ER -