Evaluation of suspected local recurrence in head and neck cancer: A comparison between PET and PET/CT for biopsy proven lesions

Background: F-18-FDG PET has a high accuracy for re-staging of head and neck cancer. The purpose of this study was to determine whether the diagnostic accuracy can be further improved with integrated PET/CT. Materials and Methods: Forty-nine patients with a mean age of 59 18 years were studied retrospectively. Histo-pathological verification was available either from complete tumor resection with or without lymph node dissection (n = 27) or direct endoscopic biopsy (n = 16) or ultrasound guided biopsy (it = 6). Two reviewers blinded to the pathological findings read all PET images in consensus. An experienced radiologist was added for the interpretation of the PET/CT images. Results: Tissue verification was available for 110 lesions in 49 patients. Sixty-seven lesions (61 %)were biopsy positive and 43 (39%) were negative for malignant disease. PET and PET/CT showed an overall accuracy for cancer detection of 84 and 88% (p = 0.06), respectively. Sensitivity and specificity for PET were 78 and 93% versus 84 (p=NS) and 95% (p=NS) with PET/CT. A patient-by-patient analysis yielded a sensitivity, specificity and accuracy for PET of 80, 56 and 76%, compared to 88% (p = NS), 78% (p = NS) and 86% (p = 0.06) for PET/CT. Conclusion: The results of this study indicate that PET/CT does not significantly improve the detection of recurrence of head and neck cancer. However, a trend towards improved accuracy was observed (p = 0.06). (c) 2006 Elsevier Ireland Ltd. All fights reserved.