Summary of Published Data: Results
| Median F/U after PET (months: range) | Index (%)* | Fraction of pts with pos primary site or heminecks (prevalence) | Δt from RT to PET (weeks: median or range) | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PET or PET/CT | Primary site | Necks | Dedicated NM reader? | ||||||||||||
| Study | PET criteria | Gold standard | Sen | Spec | PPV | NPV | Sen | Spec | PPV | NPV | |||||
| Yao (66) | Some PET/CT | Focal uptake | Bx, ND, clin F/U | No data | 86 | 90 | 54 | 97 | 100 | 96 | 77 | 100 | Primary: 19%; neck: 15% | No details (“most scans 3–5 mo after RT”) | Yes |
| McColumn (132) | PET | 2 NM physicians read scans as pos or neg; no details | Bx, ND, overt clin recurrence | 20 (16–31)† | 100 | 65 | 27 | 100 | 67 | 53 | 46 | 73 | 3/26 (11%) after ICT; 9/37 (24%) after CRT | 4–12 | Yes |
| 67‡ | 57‡ | 33‡ | 84‡ | ||||||||||||
| Ware (133) | PET | Focal uptake > background; nonphysiologic | Bx, clin F/U | 55 | Locoregional 19/46 (51%) | >6 wk after op; >2 mo after RT | Yes | ||||||||
| Yao (75) | Either | Focal uptake | Bx, clin F/U | 26 (12–57) | —§ | —§ | —§ | —§ | 100 | 94 | 43 | 100 | Neck: 3/70 (4%) | 15 (5–29; 41% 12–20 wk) | Yes |
| Porceddu (74) | PET | Not specified | Bx, clin F/U | 34 | —§ | —§ | —§ | —§ | 83 | 93 | 71 | 97 | Neck: 6/39 (15%) | 12 (8–32; 39% 8–12 wk) | Yes |
| Brkovich (134) | PET | NM physician read scans as pos or neg | All had ND | —§ | —§ | —§ | —§ | 76 | 65 | 33 | 92 | Neck: 4/21 (19%) | 9 (7–12) | No | |
| Andrade (68) | PET/CT | Focal: moderate or intense | Bx, ND, clin F/U | 17 (4.5–34) | Locoregional: 13/28 (46%) | 8 (4–16) | Yes | ||||||||
| Gourin (69) | PET/CT | Uptake “significantly higher than muscle or blood pool, fusing to lymph node on CT” | All had planned ND | NA | —§ | —§ | —§ | —§ | 40 | 25 | 18 | 50 | Neck: 5/17 (29%) | 8–10 | Yes |
| Nayak (70) | PET/CT | “Radiologist impression” | ND, clin F/U | 18 (5 minimum) | —§ | —§ | —§ | —§ | 87 | 91 | 70 | 97 | Neck: 10/43 (23%) | 8–26 | Yes |
| Tan (135) | PET | “Residual hypermetabolic uptake” | ND or clin F/U | 20 (10–55) | —§ | —§ | —§ | —§ | 25 | 83 | 15 | 90 | Neck: 8/72 (11%) | 10 (5–22) | No (unclear) |
| Yao (136) | Either | Focal uptake | ND, Bx, overt clin progression | 29 | 86 | 86 | 32 | 99 | 86 | 97 | 70 | 98 | Primary: 37/188 (20%); neck: 14/188 (7.5%) | 15 (5.1–44; 74% in 10–20 wk) | Yes |
| Ong (67) | PET/CT | Abnormal (nonphysiologic) focal uptake, fusing to nodes on CT | ND or clin F/U | 37 (excluding DOD or RD: 43 mo) | NA | 95 | NA | 97 | 71 | 89 | 38 | 97 | Neck: 7/84 (8%) | 12 (8–27) | Yes |
| 80‖ | 74‖ | 40‖ | 94‖ | ||||||||||||
↵* Only locoregional index values were reported by Ware (PPV, 95%; NPV, 83%) and Andrade (sensitivity, 76%; specificity, 93%; PPV, 90%; NPV, 82%).
↵† Follow-up time for patients who had no neck dissection.
↵‡ When considering ND and clinical follow-up.
↵§ Not reported or not primary objective.
↵‖ Residual enlarged lymph node only.
Bx = biopsy; clin = clinical; CRT = chemoradiotherapy; DOD = death of disease; RD = recurrent disease; Δt = time interval; F/U = follow-up; ICT = induction chemotherapy; NA = not applicable; ND = neck dissection; neg = negative; NM = nuclear medicine; pos = positive; pts = patients; RT = radiotherapy; sen = sensitivity; spec = specificity.