Identification of distant metastases with positron-emission tomography-computed tomography in patients with previously untreated head and neck cancer

Christine G. Gourin, Tammara Watts, Hadyn T. Williams, Vijay S. Patel, Paul A. Bilodeau, Teresa A. Coleman

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

OBJECTIVES: To investigate the utility of positron-emission tomography-computed tomography (PET-CT) in identifying distant metastatic disease in patients with previously untreated head and neck squamous cell cancer (HNSCC) prior to definitive treatment. MATERIALS AND METHODS: Retrospective analysis of 27 consecutive patients with previously untreated HNSCC who underwent PET-CT imaging in addition to chest radiography (CXR) as part of their metastatic workup. RESULTS: The majority of patients (89%) had TNM stage III or IV disease. PET-CT was suspicious for pulmonary malignancy in four (15%) patients and indeterminate in one (4%) patient. CXR was suspicious for pulmonary malignancy in two (7%) patients. Pulmonary metastases or a new lung primary was present in 3 (11%) patients: 3 of 4 (75%) patients with positive PET-CT scans and 0 of 23 (0%) patients with negative or indeterminate PET-CT scans compared with 2 of 2 (100%) patients with positive CXR and 1 of 25 (4%) patients with negative CXR. The sensitivity and specificity of PET-CT in predicting pulmonary malignancy was 100% and 96%, respectively, with a positive predictive value of 75% and a negative predictive value of 100%. The sensitivity and specificity of CXR in predicting pulmonary malignancy was 67% and 100%, respectively, with a positive predictive value of 100% and a negative predictive value of 96%. Including nonpulmonary sites, the overall incidence of distant metastatic disease was 19% (5/27) with 11% (3/27) unsuspected prior to PET-CT. CONCLUSIONS: PET-CT improves detection of metastatic disease in the high-risk patient and should be performed as part of the routine pretreatment evaluation of patients with advanced stage HNSCC.

Original languageEnglish
Pages (from-to)671-675
Number of pages5
JournalLaryngoscope
Volume118
Issue number4
DOIs
StatePublished - Apr 2008
Externally publishedYes

Fingerprint

Head and Neck Neoplasms
Neoplasm Metastasis
Squamous Cell Neoplasms
Lung
Head
Positron Emission Tomography Computed Tomography
Neoplasms
Sensitivity and Specificity
Radiography
Thorax

Keywords

  • Distant metastases
  • Head and neck neoplasms
  • Positron-emission tomography-computed tomography
  • Pulmonary metastases
  • Screening
  • Squamous cell cancer

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Identification of distant metastases with positron-emission tomography-computed tomography in patients with previously untreated head and neck cancer. / Gourin, Christine G.; Watts, Tammara; Williams, Hadyn T.; Patel, Vijay S.; Bilodeau, Paul A.; Coleman, Teresa A.

In: Laryngoscope, Vol. 118, No. 4, 04.2008, p. 671-675.

Research output: Contribution to journalArticle

Gourin, Christine G. ; Watts, Tammara ; Williams, Hadyn T. ; Patel, Vijay S. ; Bilodeau, Paul A. ; Coleman, Teresa A. / Identification of distant metastases with positron-emission tomography-computed tomography in patients with previously untreated head and neck cancer. In: Laryngoscope. 2008 ; Vol. 118, No. 4. pp. 671-675.
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abstract = "OBJECTIVES: To investigate the utility of positron-emission tomography-computed tomography (PET-CT) in identifying distant metastatic disease in patients with previously untreated head and neck squamous cell cancer (HNSCC) prior to definitive treatment. MATERIALS AND METHODS: Retrospective analysis of 27 consecutive patients with previously untreated HNSCC who underwent PET-CT imaging in addition to chest radiography (CXR) as part of their metastatic workup. RESULTS: The majority of patients (89{\%}) had TNM stage III or IV disease. PET-CT was suspicious for pulmonary malignancy in four (15{\%}) patients and indeterminate in one (4{\%}) patient. CXR was suspicious for pulmonary malignancy in two (7{\%}) patients. Pulmonary metastases or a new lung primary was present in 3 (11{\%}) patients: 3 of 4 (75{\%}) patients with positive PET-CT scans and 0 of 23 (0{\%}) patients with negative or indeterminate PET-CT scans compared with 2 of 2 (100{\%}) patients with positive CXR and 1 of 25 (4{\%}) patients with negative CXR. The sensitivity and specificity of PET-CT in predicting pulmonary malignancy was 100{\%} and 96{\%}, respectively, with a positive predictive value of 75{\%} and a negative predictive value of 100{\%}. The sensitivity and specificity of CXR in predicting pulmonary malignancy was 67{\%} and 100{\%}, respectively, with a positive predictive value of 100{\%} and a negative predictive value of 96{\%}. Including nonpulmonary sites, the overall incidence of distant metastatic disease was 19{\%} (5/27) with 11{\%} (3/27) unsuspected prior to PET-CT. CONCLUSIONS: PET-CT improves detection of metastatic disease in the high-risk patient and should be performed as part of the routine pretreatment evaluation of patients with advanced stage HNSCC.",
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AU - Bilodeau, Paul A.

AU - Coleman, Teresa A.

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AB - OBJECTIVES: To investigate the utility of positron-emission tomography-computed tomography (PET-CT) in identifying distant metastatic disease in patients with previously untreated head and neck squamous cell cancer (HNSCC) prior to definitive treatment. MATERIALS AND METHODS: Retrospective analysis of 27 consecutive patients with previously untreated HNSCC who underwent PET-CT imaging in addition to chest radiography (CXR) as part of their metastatic workup. RESULTS: The majority of patients (89%) had TNM stage III or IV disease. PET-CT was suspicious for pulmonary malignancy in four (15%) patients and indeterminate in one (4%) patient. CXR was suspicious for pulmonary malignancy in two (7%) patients. Pulmonary metastases or a new lung primary was present in 3 (11%) patients: 3 of 4 (75%) patients with positive PET-CT scans and 0 of 23 (0%) patients with negative or indeterminate PET-CT scans compared with 2 of 2 (100%) patients with positive CXR and 1 of 25 (4%) patients with negative CXR. The sensitivity and specificity of PET-CT in predicting pulmonary malignancy was 100% and 96%, respectively, with a positive predictive value of 75% and a negative predictive value of 100%. The sensitivity and specificity of CXR in predicting pulmonary malignancy was 67% and 100%, respectively, with a positive predictive value of 100% and a negative predictive value of 96%. Including nonpulmonary sites, the overall incidence of distant metastatic disease was 19% (5/27) with 11% (3/27) unsuspected prior to PET-CT. CONCLUSIONS: PET-CT improves detection of metastatic disease in the high-risk patient and should be performed as part of the routine pretreatment evaluation of patients with advanced stage HNSCC.

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KW - Pulmonary metastases

KW - Screening

KW - Squamous cell cancer

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