Follow up imaging of oral,oropharyngeal and hypopharyngeal cancer patients: Comparison of PET-CT and MRI post treatment |
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| Institution: | 1. Head and Neck Oncology Fellow, Department of Oral and Maxillofacial Surgery, Head and Neck Unit, Royal Derby Hospital, UK;2. Maxillofacial/Head and Neck Surgeon, Department of Oral and Maxillofacial Surgery, Head and Neck Unit, Royal Derby Hospital, UK;3. Nuclear Medicine Physician and Radiologist, Nuclear Medicine Department, Royal Derby Hospital, UK;4. ENT/Head and Neck Surgeon, Department of Otorhinolaryngology, Head and Neck Unit, Royal Derby Hospital, UK;1. Maxillo-facial Surgery Department, Univeristy of Rome “La Sapienza”, Rome, Italy;2. Radiology Department, Univeristy of Rome “La Sapienza”, Rome, Italy;1. Oral and Maxillofacial Surgery, Faculty of Dental Medicine for Girls, Al Azhar University, 11727 Yusuf Abas Street, Nasr City, Cairo, Egypt;2. Oral and Maxillofacial Surgery, Collage of Dentistry, Qassim University, Postal Box 1162, Qassim Region, Al-Mulida, North of Prince Nayef bin Abdulaziz International Airport, Saudi Arabia;3. Faculty of Dental Medicine for Girls, Al Azhar University, 11727 Yusuf Abas Street, Nasr City, Cairo, Egypt;1. Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588 Japan;2. Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588 Japan;1. Department of Oral and Maxillofacial Plastic Surgery (Head: A.C. Kübler), University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany;2. Comprehensive Cancer Center Mainfranken (Head: R.C. Bargou), University Hospital of Würzburg, Josef-Schneider-Str. 6, 97080, Würzburg, Germany;3. Interdisciplinary Center for Clinical Research (Head: M. Goebeler), University Hospital of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany;4. Department of Oral and Maxillofacial Plastic Surgery (Head: J. Hoffmann), University Hospital of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany |
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| Abstract: | There is currently no consensus as to the ideal timing, frequency and modality of imaging for follow up of head and neck cancer patients. The aim of this study was to analyze the diagnostic accuracy of PET-CT versus MRI, and imaging at 3 versus 6 months for follow up of head and neck cancer patients treated with curative intent with no clinical signs of treatment failure.Materials and methodsA retrospective study was performed for all head and neck cancers treated with curative intent at the Royal Derby Hospital. Data collected included demographic information, site of primary cancer, staging, treatment provided, type of follow up imaging performed and results of follow up imaging. Inclusion in the study was for oral, oropharyngeal and hypopharyngeal cancers treated with curative intent, asymptomatic patients, those who have had follow up imaging within 6 months of treatment, and those followed up for at least 2.5 years since treatment.ResultsA total of 140 patients were included in the study. 25% of patients had evidence of recurrent/metastatic disease on imaging, 60% of which were identified within 6 months post treatment. The majority (60%) of failures were due to distant metastases. The sensitivity and specificity of both MRI and PET-CT was higher at 6 months post-treatment compared to 3 months post-treatment. Overall the sensitivity and specificity for PET-CT and MRI within 3–6 months post treatment were 94.7% and 83.5% and 60% and 85.7% respectively for identifying treatment failure.ConclusionFollow up Imaging at 6 months post treatment is more likely to accurately identify treatment failures with fewer false positives than imaging at 3 months. PET-CT is preferable to MRI for identifying post treatment locoregional and distant treatment failure. |
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| Keywords: | Follow up imaging Oral cancer Oropharyngeal cancer PET CT FDG PET MRI |
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