RT Journal Article
SR Electronic
T1 Negative Predictive Value of Surveillance PET/CT in Head and Neck Squamous Cell Cancer
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1632
OP 1636
DO 10.3174/ajnr.A3494
VO 34
IS 8
A1 M. McDermott
A1 M. Hughes
A1 T. Rath
A1 J.T. Johnson
A1 D.E. Heron
A1 G.J. Kubicek
A1 S.W. Kim
A1 R.L. Ferris
A1 U. Duvvuri
A1 J.P. Ohr
A1 B.F. Branstetter
YR 2013
UL http://www.ajnr.org/content/34/8/1632.abstract
AB BACKGROUND AND PURPOSE: Optimizing the utilization of surveillance PET/CT in treated HNSCC is an area of ongoing research. Our aim was to determine the negative predictive value of PET/CT in patients with treated head and neck squamous cell cancer and to determine whether negative PET/CT reduces the need for further imaging surveillance. MATERIALS AND METHODS: We evaluated patients with treated HNSCC who underwent posttreatment surveillance PET/CT. During routine clinical readouts, scans were categorized as having negative, probably negative, probably malignant, or malignant findings. We followed patients clinically and radiographically for at least 12 months from their last PET/CT (mean, 26 months; median, 28 months; range, 12–89 months) to determine recurrence rates. All suspected recurrences underwent biopsy for confirmation. RESULTS: Five hundred twelve patients (1553 scans) were included in the study. Two hundred fourteen patients had at least 1 PET/CT with negative findings. Of the 214 patients with a scan with negative findings, 19 (9%) eventually experienced recurrence, resulting in a NPV of 91%. In addition, a subgroup of 114 patients with 2 consecutive PET/CT examinations with negative findings within a 6-month period was identified. Only 2 recurrences were found in this group, giving a NPV of 98%. CONCLUSIONS: In patients treated for HNSCC, a single PET/CT with negative findings carries a NPV of 91%, which is not adequate to defer further radiologic surveillance. Two consecutive PET/CT examinations with negative findings within a 6-month period, however, resulted in a NPV of 98%, which could obviate further radiologic imaging in the absence of clinical signs of recurrence. HNSCChead and neck squamous cell carcinomaNPVnegative predictive valueTtumor