Top

Published in:

01-04-2016 | Head and Neck

FDG-PET/contrast-enhanced CT as a post-treatment tool in head and neck squamous cell carcinoma: comparison with FDG-PET/non-contrast-enhanced CT and contrast-enhanced CT

Authors: Yuko Suenaga, Kazuhiro Kitajima, Takeaki Ishihara, Ryohei Sasaki, Naoki Otsuki, Ken-ichi Nibu, Tsutomu Minamikawa, Naomi Kiyota, Kazuro Sugimura

Published in: European Radiology | Issue 4/2016

Abstract

Objective

To evaluate the accuracy of PET/CT using ¹⁸F-fluorodeoxyglucose (FDG) with IV contrast for suspected recurrent head and neck squamous cell carcinoma (HNSCC).

Methods

One hundred and seventy patients previously treated for HNSCC underwent PET/CT, consisting of non-contrast-enhanced and contrast-enhanced CT, to investigate suspected recurrence. Diagnostic performance of PET/contrast-enhanced CT (PET/ceCT), PET/non-contrast-enhanced CT (PET/ncCT) and contrast-enhanced CT (ceCT) for local or regional recurrence, distant metastasis, overall recurrence and second primary cancer was evaluated. The reference standard included histopathology, treatment change and imaging follow-up.

Results

The patient-based areas under the receiver operating characteristic curves (AUC) for ceCT, PET/ncCT and PET/ceCT were 0.82, 0.96 and 0.98 for local recurrence, 0.73, 0.86 and 0.86 for regional recurrence, 0.86, 0.91 and 0.92 for distant metastasis, 0.72, 0.86 and 0.87 for overall recurrence, and 0.86, 0.89 and 0.91 for a second primary cancer. Both PET/ceCT and PET/ncCT statistically showed larger AUC than ceCT for recurrence, and the difference between PET/ceCT and PET/ncCT for local recurrence reached a significant level (p = 0.039). The accuracy of PET/ceCT for diagnosing overall recurrence was high, irrespective of the time interval after the last treatment (83.3–94.1 %).

Conclusion

FDG-PET/CT was a more accurate HNSCC restaging tool than ceCT. The added value of ceCT at FDG-PET/CT is minimal.

Key Points

• FDG-PET/CT is a more accurate post-treatment surveillance tool than ceCT for HNSCC.

• FDG-PET/ceCT was useful, irrespective of the time interval after the last treatment.

• FDG-PET/ceCT showed high negative predictive value and limited positive predictive value.

• The added value of ceCT at FDG-PET/CT is minimal and likely not clinically relevant.

Ang KK, Trotti A, Brown BW et al (2001) Randomized trial addressing risk features and time factors of surgery plus radiotherapy in advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys 51:571–578CrossRefPubMed

Lell M, Baum U, Greess H et al (2000) Head and neck tumors: imaging recurrent tumor and post-therapeutic changes with CT and MRI. Eur J Radiol 33:239–247CrossRefPubMed

Krabbe CA, Pruim J, Dijkstra PU et al (2009) ¹⁸F-FDG PET as a routine posttreatment surveillance tool in oral and oropharyngeal squamous cell carcinoma: a prospective study. J Nucl Med 50:1940–1947CrossRefPubMed

Salaun PY, Abgral R, Querellou S et al (2007) Does ¹⁸fluoro-fluorodeoxyglucose positron emission tomography improve recurrence detection in patients treated for head and neck squamous cell carcinoma with negative clinical follow-up? Head Neck 29:1115–1120CrossRefPubMed

Liu T, Xu W, Yan WL, Ye M, Bai YR, Huang G (2007) FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review. Radiother Oncol 85:327–335CrossRefPubMed

Isles MG, McConkey C, Mehanna HM (2008) A systematic review and meta-analysis of the role of positron emission tomography in the follow up of head and neck squamous cell carcinoma following radiotherapy or chemoradiotherapy. Clin Otolaryngol 33:210–222CrossRefPubMed

Gourin CG, Watts T, Williams HT, Patel VS, Bilodeau PA, Coleman TA (2009) Identification of distant metastases with PET-CT in patients with suspected recurrent head and neck cancer. Laryngoscope 119:703–706CrossRefPubMed

Abgral R, Querellou S, Potard G et al (2009) Does ¹⁸F-FDG PET/CT improve the detection of posttreatment recurrence of head and neck squamous cell carcinoma in patients negative for disease on clinical follow-up? J Nucl Med 50:24–29CrossRefPubMed

Kao J, Vu HL, Genden EM et al (2009) The diagnostic and prognostic utility of positron emission tomography/computed tomography-based follow-up after radiotherapy for head and neck cancer. Cancer 115:4586–4594CrossRefPubMed

10.

Gupta T, Master Z, Kannan S et al (2011) Diagnostic performance of post-treatment FDG PET or FDG PET/CT imaging in head and neck cancer: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 38:2083–2095CrossRefPubMed

11.

Xu GZ, Guan DJ, He ZY (2011) ¹⁸FDG-PET/CT for detecting distant metastases and second primary cancers in patients with head and neck cancer. A meta-analysis. Oral Oncol 47:560–565CrossRefPubMed

12.

Beswick DM, Gooding WE, Johnson JT, Branstetter BF 4th (2012) Temporal patterns of head and neck squamous cell carcinoma recurrence with positron-emission tomography/computed tomography monitoring. Laryngoscope 122:1512–1517CrossRefPubMedPubMedCentral

13.

Yi JS, Kim JS, Lee JH et al (2012) ¹⁸F-FDG PET/CT for detecting distant metastases in patients with recurrent head and neck squamous cell carcinoma. J Surg Oncol 106:708–712CrossRefPubMed

14.

Ho AS, Tsao GJ, Chen FW et al (2013) Impact of positron emission tomography/computed tomography surveillance at 12 and 24 months for detecting head and neck cancer recurrence. Cancer 119:1349–1356CrossRefPubMed

15.

Kim JW, Roh JL, Kim JS et al (2013) ¹⁸F-FDG PET/CT surveillance at 3-6 and 12 months for detection of recurrence and second primary cancer in patients with head and neck squamous cell carcinoma. Br J Cancer 109:2973–2979CrossRefPubMedPubMedCentral

16.

Branstetter BF 4th, Blodgett TM, Zimmer LA et al (2005) Head and neck malignancy: is PET/CT more accurate than PET or CT alone? Radiology 235:580–586CrossRefPubMed

17.

Kostakoglu L, Fardanesh R, Posner M et al (2013) Early detection of recurrent disease by FDG-PET/CT leads to management changes in patients with squamous cell cancer of the head and neck. Oncologist 18:1108–1117CrossRefPubMedPubMedCentral

18.

Rangaswamy B, Fardanesh MR, Genden EM et al (2013) Improvement in the detection of locoregional recurrence in head and neck malignancies: F-18 fluorodeoxyglucose-positron emission tomography/computed tomography compared to high-resolution contrast-enhanced computed tomography and endoscopic examination. Laryngoscope 123:2664–2669CrossRefPubMed

19.

McDermott M, Hughes M, Rath T et al (2013) Negative predictive value of surveillance PET/CT in head and neck squamous cell cancer. AJNR Am J Neuroradiol 34:1632–1636CrossRefPubMed

20.

Rabalais AG, Walvekar R, Nuss D et al (2009) Positron emission tomography-computed tomography surveillance for the node-positive neck after chemoradiotherapy. Laryngoscope 119:1120–1124CrossRefPubMed

21.

Jovanovic A, van der Tol IG, Kostense PJ et al (1994) Second respiratory and upper digestive tract cancer following oral squamous cell carcinoma. Eur J Cancer B Oral Oncol 30B:225–229CrossRefPubMed

22.

Coleman ER, Delbeke D, Guiberteau MJ et al (2005) Concurrent PET/CT with an integrated imaging system: intersociety dialogue from the joint working group of the American College of Radiology, the Society of Nuclear Medicine, and the Society of Computed Body Tomography and Magnetic Resonance. J Nucl Med 46:1225–1239PubMed

23.

IAEA (2008) Radiation protection in newer medical imaging techniques: PET/CT (Safety Reports Series no. 58). http://www-pub.iaea.org/MTCD/publications/PDF/pub1343_web.pdf. Accessed 13 July 2015

24.

Kuhn FP, Hüllner M, Mader CE et al (2014) Contrast-enhanced PET/MR imaging versus contrast-enhanced PET/CT in head and neck cancer: how much MR information is needed? J Nucl Med 55:551–558CrossRefPubMed

25.

Kubiessa K, Purz S, Gawlitza M et al (2014) Initial clinical results of simultaneous ¹⁸F-FDG PET/MRI in comparison to 18F-FDG PET/CT in patients with head and neck cancer. Eur J Nucl Med Mol Imaging 41:639–648CrossRefPubMed

26.

Koshkareva Y, Branstetter BF 4th, Gaughan JP, Ferris RL (2014) Predictive accuracy of first post-treatment PET/CT in HPV-related oropharyngeal squamous cell carcinoma. Laryngoscope 124:1843–1847CrossRefPubMed

Title: FDG-PET/contrast-enhanced CT as a post-treatment tool in head and neck squamous cell carcinoma: comparison with FDG-PET/non-contrast-enhanced CT and contrast-enhanced CT
Authors: Yuko Suenaga
Kazuhiro Kitajima
Takeaki Ishihara
Ryohei Sasaki
Naoki Otsuki
Ken-ichi Nibu
Tsutomu Minamikawa
Naomi Kiyota
Kazuro Sugimura
Publication date: 01-04-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 4/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3902-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

FDG-PET/contrast-enhanced CT as a post-treatment tool in head and neck squamous cell carcinoma: comparison with FDG-PET/non-contrast-enhanced CT and contrast-enhanced CT

Abstract

Objective

Methods

Results

Conclusion

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Key Points

Please log in to get access to this content

Other articles of this Issue 4/2016

Elastographic features of triple negative breast cancers

US characteristics for the prediction of neoplasm in gallbladder polyps 10 mm or larger

Lumbar annulus fibrosus biomechanical characterization in healthy children by ultrasound shear wave elastography

Clinical utility of dual-energy contrast-enhanced spectral mammography for breast microcalcifications without associated mass: a preliminary analysis

Core needle biopsy could reduce diagnostic surgery in patients with anaplastic thyroid cancer or thyroid lymphoma

What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging?