Screening for distant metastases in head and neck cancer patients using FDG-PET and chest CT: validation of an algorithm

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• 作者：Asaf Senft ; Otto S. Hoekstra ; Birgit I. Witte…
• 刊名：European Archives of Oto-Rhino-Laryngology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：273
• 期：9
• 页码：2643-2650
• 全文大小：574 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Otorhinolaryngology
  Neurosurgery
  Head and Neck Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1434-4726
• 卷排序：273

文摘

In patients with head and neck squamous cell carcinoma and high-risk factors, the combination of whole body FDG-PET and contrast-enhanced chest CT has the highest sensitivity and accuracy when screening for distant metastases. The aim of the present study was to retrospectively validate an earlier developed algorithm for interpreting the combination of screening PET and CT. The test cohort consisted of 47 consecutive HNSCC patients with high-risk factors for distant metastases, who had previously undergone FDG-PET and CT and had a minimum 12 months of follow-up. In 12 (26 %) patients, distant metastases were detected during screening or within 12-month follow-up. In patients with locoregional control during follow-up, the sensitivity and specificity were 55 % (95 % CI 23–83 %) and 97 % (95 % CI 82–99 %), respectively, for chest CT, 55 % (95 % CI 23–83 %) and 100 % (95 % CI 88–100 %), respectively, for PET and 73 % (95 % CI 39–94 %) and 100 % (95 % CI 88–100 %), respectively, for the combination of PET and CT. The proposed algorithm was considered to have been validated. In this algorithm, all FDG-PET positive scans for distant metastases (regardless of interpretation of a solid lung lesion on CT) and CT scans with suspicious pulmonary lesions of less than 5-mm diameter (regardless of FDG-PET findings) are considered positive for distant metastases.KeywordsHead and neck squamous cell carcinomaDistant metastases18F-fluorodeoxyglucosePositron emission tomographyComputerized tomographyAlgorithmScreening