¹⁸F FDG PET/CT Staging of Head and Neck Cancer: Inter-observer agreement and accuracy – Results from multicenter ACRIN 6685 Clinical Trial

Abstract

No prior multicenter clinical trial reported inter-observer agreement of FDG PET/CT scans for staging of clinical N0 neck. Methods: A total of 287 participants were recruited. For visual analysis, “positive” nodal uptake of FDG was defined as uptake visually greater than activity seen in the blood pool. Results: The Negative Predictive Value of the FDG PET/CT for N0 clinical neck was 86% or above for visual assessment (86% - 88%) for the two central readers and above 90% (90% - 95%) for SUV_max 1.8 and 3.5 cutpoints for central readers and site reads. The kappa coefficients between (1) the two expert readers and (2) between central reads and site reads varied between 0.53 and 0.78. Conclusion: The NPV of the FDG PET/CT for N0 clinical neck was 86% or above for visual assessment and above 90% for SUV_max 1.8 and 3.5 cutpoints with moderate to substantial agreements.