Presented at the 6th International Conference on Head and Neck Cancer, August 9, 2004, Washington, DC.
PET-CT vs contrast-enhanced CT: What is the role for each after chemoradiation for advanced oropharyngeal cancer?†
Article first published online: 17 APR 2006
Copyright © 2006 Wiley Periodicals, Inc.
Head & Neck
Volume 28, Issue 6, pages 487–495, June 2006
How to Cite
Chen, A. Y., Vilaseca, I., Hudgins, P. A., Schuster, D. and Halkar, R. (2006), PET-CT vs contrast-enhanced CT: What is the role for each after chemoradiation for advanced oropharyngeal cancer?. Head Neck, 28: 487–495. doi: 10.1002/hed.20362
- Issue published online: 11 MAY 2006
- Article first published online: 17 APR 2006
- Manuscript Accepted: 24 AUG 2005
- computed tomography;
- oropharyngeal carcinoma;
The aim of our study was to assess the utility of positron emission tomography (PET) and 2 fluoro-2-deoxy-D-glucose coupled with neck CT compared with contrast-enhanced CT in predicting persistent cancer either at the primary site or cervical lymphatics in patients with oropharyngeal cancer treated with concurrent chemoradiation
Thirty consecutive patients underwent clinical examination, PET-CT, and contrast-enhanced CT to assess response after the completion of the treatment. The outcome variable was positive tissue diagnosis or negative disease at 6 months. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for the primary site as well as cervical disease.
Contrast-enhanced CT alone showed the best accuracy in detecting disease at the primary site after treatment (85.7%). Accuracy in evaluating residual tumor in the cervical lymphatics for contrast-enhanced CT and PET-CT was 59.3% and 74.1%, respectively. For evaluating the neck, PET-CT and contrast-enhanced CT demonstrated 100% NPV, but the PPV was 36.3% and 26.6%, respectively.
In this preliminary study, PET-CT seems to be superior to contrast-enhanced CT in predicting persistent disease in the neck after chemoradiation for oropharyngeal or unknown primary cancer, but not at the primary site. However, the possibility of a false-positive result in the neck remains high, and thus overtreatment may result. Even more concerning are the false-negative results. Larger, prospective studies will be important in defining the role of PET-CT in obviating the need for salvage neck dissections after chemoradiation. © 2006 Wiley Periodicals, Inc. Head Neck 28:487–495, 2006