We performed a prospective study to assess the value of positron emission tomography (PET) with 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) in the prediction of local control in irradiated head and neck squamous cell carcinomas (HNSCCs). Forty-two patients with irradiated HNSCCs underwent 49 FDG-PET scans between 3 and 6 months after the end of radiotherapy. The mean follow-up time after the first FDG-PET scan was 17 months. The result of the FDG-PET scan was true-positive in 6 patients, false-positive in 7 patients, and true-negative in 29 patients. The sensitivity, specificity, positive predictive value, and negative predictive value of FDG-PET scanning were 100%, 81%, 46%, and 100%, respectively. We conclude that FDG-PET scanning is useful for prediction of therapy outcome in irradiated HNSCCs. No biopsy is needed for at least 1 year if an FDG-PET scan is negative. If the scan is positive and the biopsy is negative, decreased FDG uptake measured in a follow-up scan indicates that a local recurrence is unlikely.
McGuirtWFGrevenKWilliamsDIII. PET scanning in head and neck oncology: A review. Head Neck1998; 20: 208–15.
2.
FischbeinNJAAssarOSCaputoGR. Clinical utility of positron emission tomography with 18F-fluorodeoxyglucose in detecting residual/recurrent squamous cell carcinoma of the head and neck. AJNR Am J Neuroradiol1998; 19: 1189–96.
3.
SomPMBillerHF. Computed tomography of the neck in the postoperative patient: Radical neck dissection and the myocutaneous flap. Radiology1983; 148: 157–60.
4.
RuggTSaundersMIDischeS. Smoking and mucosal reactions to radiotherapy. Br J Radiol1990; 63: 554–6.
5.
TerhaardCHBongersVvan RijkPPHordijkGJ. F-18-fluoro-deoxy-glucose positron emission tomography scanning in detection of local recurrence after radiotherapy for laryngeal/pharyngeal cancer. Head Neck2001; 23: 933–41.
6.
McGuirtWFGrevenKMKeyesJWJrWilliamsDWIIIWatsonN. Laryngeal radionecrosis versus recurrent cancer: A clinical approach. Ann Otol Rhinol Laryngol1998; 107: 293–6.
7.
PaulusPSambonAVivegnisD. 18FDG-PET for the assessment of primary head and neck tumors: Clinical, computed tomography, and histopathological correlation in 38 patients. Laryngoscope1998; 108: 1578–83.
8.
JabourBAChoiYHohCK. Extracranial head and neck: PET imaging with 2-[F-18]fluoro-2-deoxy-d-glucose and MR imaging correlation. Radiology1993; 186: 27–35.
9.
KeyesJWJrWatsonNEJrWilliamsDWIIIGrevenKMMcGuirtWF. FDG PET in head and neck cancer. AJR Am J Roentgenol1997; 169: 1663–9.
10.
FoehrenbachHConessaCMaszelinPKossowskiMPoncetJLGaillardJF. Tomographie par émission de positrons en oncologie de la tête et du cou. Ann Otolaryngol Chir Cervicofac2001; 118: 365–72.
11.
AkIBloklandJAPauwelsEKStokkelMP. The clinical value of 18F-FDG detection with a dual-head coincidence camera: A review. Eur J Nucl Med2001; 28: 763–78.
12.
AnzaiYCarrollWRQuintDJ. Recurrence of head and neck cancer after surgery or irradiation: Prospective comparison of 2-deoxy-2-[F-18]fluoro-d-glucose PET and MR imaging diagnoses. Radiology1996; 200: 135–41.
13.
LapelaMGrenmanRKurkiT. Head and neck cancer: Detection of recurrence with PET and 2-[F-18]fluoro-2-deoxy-d-glucose. Radiology1995; 197: 205–11.
14.
UematsuHSadatoNYonekuraY. Coregistration of FDG PET and MRI of the head and neck using normal distribution of FDG. J Nucl Med1998; 39: 2121–27.
15.
HudginsPABursonJGGussackGSGristWJ. CT and MR appearance of recurrent malignant head and neck neoplasms after resection and flap reconstruction. AJNR Am J Neuroradiol1994; 15: 1689–94.
16.
YoungHBaumRCremeriusU. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: Review and EORTC 1999 recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer1999; 35: 1773–82.
17.
Bar-ShalomRValdiviaAYBlaufoxMD. PET imaging in oncology. Semin Nucl Med2000; 30: 150–85.
18.
RigoPPaulusPKaschtenBJ. Oncological applications of positron emission tomography with fluorine-18 fluorodeoxyglucose. Eur J Nucl Med1996; 23: 1641–74.
19.
WarburgOWindFNeglersE. On the metabolism of the tumors in the body. In: WarburgO, ed. Metabolism of tumors. London, England: Constable, 1930: 254–70.
20.
PengNJYenSHLiuWSTsayDGLiuRS. Evaluation of the effect of radiation therapy to nasopharyngeal carcinoma by positron emission tomography with 2-(F-18) fluoro-2-deoxy-d-glucose. Clin Positron Imaging2000; 3: 51–6.
21.
CheonGJChungJKSoY. Diagnostic accuracy of F-18 FDG-PET in the assessment of posttherapeutic recurrence of head and neck cancer. Clin Positron Imaging1999; 2: 197–204.
22.
PaiMParkCHSuhJHKohJH. Fluorine-18 fluorodeoxyglucose imaging using dual-head coincidence positron emission tomography without attenuation correction in patients with head and neck cancer. Clin Nucl Med1999; 24: 495–500.
23.
HaenggeliCADulguerovPSlosmanD. Rôle de la tomographie par émission de positrons avec le 18-fluorodeoxyglucose (PET-FDG) dans la détection précoce d'une non-stérilisation tumorale des carcinomes bucco-pharyngo-laryngés. Schweiz Med WochenschrSuppl2000; 116: 8S–11S.
24.
FarberLABernardFMacHtayM. Detection of recurrent head and neck squamous cell carcinomas after radiation therapy with 2–18F-fluoro-2-deoxy-d-glucose positron emission tomography. Laryngoscope1999; 109: 970–5.
25.
ChaikenLRegeSHohC. Positron emission tomography with fluorodeoxyglucose to evaluate tumor response and control after radiation therapy. Int J Radiat Oncol Biol Phys1993; 27: 455–64.
26.
KresnikEMikoschPGallowitschHJ. Evaluation of head and neck cancer with 18F-FDG PET: A comparison with conventional methods. Eur J Nucl Med2001; 28: 816–21.
27.
McGuirtWFGrevenKMKeyesJWJr. Positron emission tomography in the evaluation of laryngeal carcinoma. Ann Otol Rhinol Laryngol1995; 104: 274–8.
28.
ConessaCClémentPFoehrenbachH. Intérêt de la tomographie par émission de positrons dans le suivi postthérapeutique des carcinomes épidermoïdes de la tête et du cou. Rev Laryngol Otol Rhinol (Bord)2001; 122: 253–8.
29.
GrevenKMWilliamsDWIIIKeyesJWJr. Positron emission tomography of patients with head and neck carcinoma before and after high dose irradiation. Cancer1994; 74: 1355–9.
30.
StokkelMPTerhaardCHHordjikGJvan RijkPP. The detection of local recurrent head and neck cancer with fluorine- 18 fluorodeoxyglucose dual-head positron emission tomography. Eur J Nucl Med1999; 26: 767–73.
