Assessment of outcomes with delayed (18)F-FDG PET-CT response assessment in head and neck squamous cell carcinoma

F Slevin; Manil Subesinghe; S Ramasamy; Mehmet Sen; A F Scarsbrook; R J D Prestwich

doi:10.1259/bjr.20140592

Assessment of outcomes with delayed (18)F-FDG PET-CT response assessment in head and neck squamous cell carcinoma

F Slevin, Manil Subesinghe, S Ramasamy, Mehmet Sen, A F Scarsbrook, R J D Prestwich

PET Imaging Centre Facility

Research output: Contribution to journal › Article › peer-review

34 Citations (Scopus)

Abstract

OBJECTIVE: To assess the accuracy of a 4-month post-(chemo)radiotherapy 18-fludeoxyglucose ((18)F-FDG) positron emission tomography (PET)-CT for head and neck squamous cell carcinoma (HNSCC).

METHODS: 105 patients who underwent a baseline and response assessment (18)F-FDG PET-CT scan between 2008 and April 2013 were identified. (18)F-FDG PET-CT outcomes were analysed with reference to clinicopathological outcomes.

RESULTS: 79 of 105 (75%) (18)F-FDG PET-CT scans demonstrated a complete metabolic response; 19 of 101 (19%) for assessable primary tumours were positive; and 19 of 93 (20%) for patients with nodal disease were equivocal (n = 10) or positive (n = 9). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for primary and nodal disease were 90%, 89%, 47%, 99% and 91%, 89%, 53% and 99%, respectively. Eight of nine patients with a positive nodal response scan had clinicopathological evidence of residual nodal disease (PPV, 89%). 2 of 10 patients with equivocal nodal responses had clinicopathological evidence of residual nodal disease (PPV, 20%).

CONCLUSION: (18)F-FDG PET-CT 4 months post treatment has a very high NPV. A positive (18)F-FDG PET-CT has a high PPV for residual nodal disease. By contrast, patients who have an equivocal nodal response have a low PPV.

ADVANCES IN KNOWLEDGE: Response assessment (18)F-FDG PET-CT is a valuable tool in guiding the selective use of neck dissection following (chemo)radiotherapy for HNSCC. An equivocal lymph node response has a limited predictive value for persistent disease, and optimal management remains a clinical challenge.

Original language	English
Pages (from-to)	20140592
Journal	British Journal of Radiology
Volume	88
Issue number	1052
Early online date	8 Jul 2015
DOIs	https://doi.org/10.1259/bjr.20140592
Publication status	Published - Aug 2015

Keywords

Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Carboplatin
Carcinoma, Squamous Cell
Chemoradiotherapy
Cisplatin
Female
Fluorodeoxyglucose F18
Head and Neck Neoplasms
Humans
Male
Middle Aged
Positron-Emission Tomography
Radiopharmaceuticals
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed
Treatment Outcome
Evaluation Studies
Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1259/bjr.20140592

Cite this

@article{6a6f412977374bb3b14ce97c08f1d275,

title = "Assessment of outcomes with delayed (18)F-FDG PET-CT response assessment in head and neck squamous cell carcinoma",

abstract = "OBJECTIVE: To assess the accuracy of a 4-month post-(chemo)radiotherapy 18-fludeoxyglucose ((18)F-FDG) positron emission tomography (PET)-CT for head and neck squamous cell carcinoma (HNSCC).METHODS: 105 patients who underwent a baseline and response assessment (18)F-FDG PET-CT scan between 2008 and April 2013 were identified. (18)F-FDG PET-CT outcomes were analysed with reference to clinicopathological outcomes.RESULTS: 79 of 105 (75%) (18)F-FDG PET-CT scans demonstrated a complete metabolic response; 19 of 101 (19%) for assessable primary tumours were positive; and 19 of 93 (20%) for patients with nodal disease were equivocal (n = 10) or positive (n = 9). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for primary and nodal disease were 90%, 89%, 47%, 99% and 91%, 89%, 53% and 99%, respectively. Eight of nine patients with a positive nodal response scan had clinicopathological evidence of residual nodal disease (PPV, 89%). 2 of 10 patients with equivocal nodal responses had clinicopathological evidence of residual nodal disease (PPV, 20%).CONCLUSION: (18)F-FDG PET-CT 4 months post treatment has a very high NPV. A positive (18)F-FDG PET-CT has a high PPV for residual nodal disease. By contrast, patients who have an equivocal nodal response have a low PPV.ADVANCES IN KNOWLEDGE: Response assessment (18)F-FDG PET-CT is a valuable tool in guiding the selective use of neck dissection following (chemo)radiotherapy for HNSCC. An equivocal lymph node response has a limited predictive value for persistent disease, and optimal management remains a clinical challenge.",

keywords = "Adult, Aged, Antineoplastic Combined Chemotherapy Protocols, Carboplatin, Carcinoma, Squamous Cell, Chemoradiotherapy, Cisplatin, Female, Fluorodeoxyglucose F18, Head and Neck Neoplasms, Humans, Male, Middle Aged, Positron-Emission Tomography, Radiopharmaceuticals, Retrospective Studies, Sensitivity and Specificity, Tomography, X-Ray Computed, Treatment Outcome, Evaluation Studies, Journal Article",

author = "F Slevin and Manil Subesinghe and S Ramasamy and Mehmet Sen and Scarsbrook, {A F} and Prestwich, {R J D}",

year = "2015",

month = aug,

doi = "10.1259/bjr.20140592",

language = "English",

volume = "88",

pages = "20140592",

journal = "British Journal of Radiology",

issn = "0007-1285",

publisher = "British Institute of Radiology",

number = "1052",

}

TY - JOUR

T1 - Assessment of outcomes with delayed (18)F-FDG PET-CT response assessment in head and neck squamous cell carcinoma

AU - Slevin, F

AU - Subesinghe, Manil

AU - Ramasamy, S

AU - Sen, Mehmet

AU - Scarsbrook, A F

AU - Prestwich, R J D

PY - 2015/8

Y1 - 2015/8

N2 - OBJECTIVE: To assess the accuracy of a 4-month post-(chemo)radiotherapy 18-fludeoxyglucose ((18)F-FDG) positron emission tomography (PET)-CT for head and neck squamous cell carcinoma (HNSCC).METHODS: 105 patients who underwent a baseline and response assessment (18)F-FDG PET-CT scan between 2008 and April 2013 were identified. (18)F-FDG PET-CT outcomes were analysed with reference to clinicopathological outcomes.RESULTS: 79 of 105 (75%) (18)F-FDG PET-CT scans demonstrated a complete metabolic response; 19 of 101 (19%) for assessable primary tumours were positive; and 19 of 93 (20%) for patients with nodal disease were equivocal (n = 10) or positive (n = 9). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for primary and nodal disease were 90%, 89%, 47%, 99% and 91%, 89%, 53% and 99%, respectively. Eight of nine patients with a positive nodal response scan had clinicopathological evidence of residual nodal disease (PPV, 89%). 2 of 10 patients with equivocal nodal responses had clinicopathological evidence of residual nodal disease (PPV, 20%).CONCLUSION: (18)F-FDG PET-CT 4 months post treatment has a very high NPV. A positive (18)F-FDG PET-CT has a high PPV for residual nodal disease. By contrast, patients who have an equivocal nodal response have a low PPV.ADVANCES IN KNOWLEDGE: Response assessment (18)F-FDG PET-CT is a valuable tool in guiding the selective use of neck dissection following (chemo)radiotherapy for HNSCC. An equivocal lymph node response has a limited predictive value for persistent disease, and optimal management remains a clinical challenge.

AB - OBJECTIVE: To assess the accuracy of a 4-month post-(chemo)radiotherapy 18-fludeoxyglucose ((18)F-FDG) positron emission tomography (PET)-CT for head and neck squamous cell carcinoma (HNSCC).METHODS: 105 patients who underwent a baseline and response assessment (18)F-FDG PET-CT scan between 2008 and April 2013 were identified. (18)F-FDG PET-CT outcomes were analysed with reference to clinicopathological outcomes.RESULTS: 79 of 105 (75%) (18)F-FDG PET-CT scans demonstrated a complete metabolic response; 19 of 101 (19%) for assessable primary tumours were positive; and 19 of 93 (20%) for patients with nodal disease were equivocal (n = 10) or positive (n = 9). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for primary and nodal disease were 90%, 89%, 47%, 99% and 91%, 89%, 53% and 99%, respectively. Eight of nine patients with a positive nodal response scan had clinicopathological evidence of residual nodal disease (PPV, 89%). 2 of 10 patients with equivocal nodal responses had clinicopathological evidence of residual nodal disease (PPV, 20%).CONCLUSION: (18)F-FDG PET-CT 4 months post treatment has a very high NPV. A positive (18)F-FDG PET-CT has a high PPV for residual nodal disease. By contrast, patients who have an equivocal nodal response have a low PPV.ADVANCES IN KNOWLEDGE: Response assessment (18)F-FDG PET-CT is a valuable tool in guiding the selective use of neck dissection following (chemo)radiotherapy for HNSCC. An equivocal lymph node response has a limited predictive value for persistent disease, and optimal management remains a clinical challenge.

KW - Adult

KW - Aged

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Carboplatin

KW - Carcinoma, Squamous Cell

KW - Chemoradiotherapy

KW - Cisplatin

KW - Female

KW - Fluorodeoxyglucose F18

KW - Head and Neck Neoplasms

KW - Humans

KW - Male

KW - Middle Aged

KW - Positron-Emission Tomography

KW - Radiopharmaceuticals

KW - Retrospective Studies

KW - Sensitivity and Specificity

KW - Tomography, X-Ray Computed

KW - Treatment Outcome

KW - Evaluation Studies

KW - Journal Article

U2 - 10.1259/bjr.20140592

DO - 10.1259/bjr.20140592

M3 - Article

C2 - 26081447

SN - 0007-1285

VL - 88

SP - 20140592

JO - British Journal of Radiology

JF - British Journal of Radiology

IS - 1052

ER -

Assessment of outcomes with delayed (18)F-FDG PET-CT response assessment in head and neck squamous cell carcinoma

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this