RT Journal Article
SR Electronic
T1 Does FDG-PET/CT improve the detection of early subclinical recurrence 6 months after treatment of HNSCC?
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 514
OP 514
VO 54
IS supplement 2
A1 Robin, Philippe
A1 Abgral, Ronan
A1 Le Roux, Pierre Yves
A1 Querellou, Solene
A1 Keromnes, Nathalie
A1 Rousset, Jean
A1 Valette, Gerald
A1 Gobel, Yves
A1 Marianowski, Rémi
A1 Salaun, Pierre
YR 2013
UL http://jnm.snmjournals.org/content/54/supplement_2/514.abstract
AB 514 Objectives Posttreatment surveillance for the recurrence of HNSCC is a diagnostic challenge. Tissue distortion from radiation and surgery can obscure early detection of recurrence by conventional follow-up approaches such as physical examination or conventional imaging. We showed in a previous prospective study (Abgral et al. J Nucl Med. 2009) the high effectiveness of FDG-PET/CT in the assessment of subclinical HNSCC recurrence 12 months after a curative treatment. The aim of this prospective study was to evaluate the effectiveness of an earlier FDG-PET/CT, at 6 months after the end of the treatment, for detection of subclinical locoregional recurrences of HNSCC or distant metastases. Methods Seventy-seven patients cured of HNSCC without any clinical evidence of recurrence were included. Whole-body FDG-PET/CT examination was performed within a mean period ± sd of 5.5 ± 1.9 months after the end of the treatment. The gold standard was histopathology or 6 months of imaging follow-up. Results The 6 months whole-body FDG-PET/CT examinations exhibited abnormal FDG uptake in 25 patients and found no suspected results of recurrence in 52 cases. Out of these 52 FDG-PET/CT considered as negative, only 1 had a recurrence (FN). Among the 25 positive FDG-PET/CT, 18 relapsed whereas 7 did not show evidence of recurrence (FP). The sensitivity and specificity of FDG-PET/CT in this study for the diagnosis of occult HNSCC recurrence were 95% (18/19) and 88% (51/58), respectively. The positive predictive value was 72% (18/25). The negative predictive value was 98% (51/52). The overall accuracy was 90% (69/77). Out of the 77 patients, FDG-PET/CT highlighted 18 (23%) subclinical recurrence. Conclusions As we shown at 12 months of the follow up, our results confirm the effectiveness of an early FDG-PET/CT evaluation in order to diagnose unsuspected recurrence even at 6 months of the end of the treatment.