PET/CT scans spot head and neck cancer return

NEW YORK (Reuters Health) - (18F)-Fluorodeoxyglucose-positron emission tomography integrated with computed tomography (PET/CT) is highly sensitive for detecting head and neck cancer recurrence, New York-based researchers report in the October issue of Cancer.

Moreover, "PET/CT scans allow for earlier detection of recurrences after treatment for head and neck cancer," lead investigator Dr. Johnny Kao told Reuters Health.

Dr. Kao and colleagues at the Mount Sinai School of Medicine analyzed 240 PET/CT scans that had been obtained from 80 patients at 4 to 6 month intervals, starting 2 to 4 months after completion of radiotherapy.

After a median follow-up of 21 months, PET/CT had a sensitivity of 92% and a specificity of 82% for detection of locoregional recurrence. Corresponding values for distant metastases or second primary tumors were 93% and 96%.

In patients with negative PET/CT findings within 6 months of radiotherapy, the 2-year progression-free survival rate was 90% and the 2-year overall survival rate was 100%. In patients with positive findings, however, rates of progression-free and overall survival were 30% and 32%, respectively.

The authors acknowledge that the PET/CT had a positive predictive value of only 42% for loco/regional recurrence.

"Although post-therapy follow-up using PET/CT is reportedly associated with a high false-positive rate in the irradiated head and neck, PET/CT appears to be a highly sensitive technique for the detection of recurrent disease," the authors conclude.

Moreover, Dr. Kao added, "negative PET/CT scans within 6 months of treatment are highly predictive of long-term freedom from recurrence."

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