The detection of local recurrent head and neck cancer with fluroine-18 fluorodeoxyglucose dual-head positron emission tomography |
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| Authors: | Marcel P M Stokkel Chris H J Terhaard Gerrit-Jan Hordijk Peter P van Rijk |
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| Institution: | (1) Department of Nuclear Medicine, University Hospital Utrecht, the Netherlands, NL;(2) Department of Radiotherapy, University Hospital Utrecht, the Netherlands, NL;(3) Department of Otolaryngology, University Hospital Utrecht, the Netherlands, NL |
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| Abstract: | Primary tumors of the larynx and hypopharynx are preferably treated with high-dose radiation therapy. In these patients,
it may be difficult to distinguish recurrent disease from post-treatment reactions. The aim of the present study was to assess
the value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in the detection of local relapses of laryngeal
or hypopharyngeal carcinoma after radiotherapy using a dual-head PET camera. Forty-eight patients (43 male, 5 female; mean
age ±SD, 61±9.5 years) with suspected recurrent laryngeal or hypopharyngeal cancer were prospectively studied. The mean interval
between initial treatment and suspicion of recurrent disease was 14.6 months (range: 3–100 months). FDG dual-head PET was
followed by endoscopy with or without biopsy under general anaesthesia within a period of 2 months in all patients. The mean
period of follow-up after FDG dual-head PET was 13.7 months. In 19 out of 31 patients with focally increased uptake, tumour
recurrence (mean diameter: 2.4 cm; range 0.4–6.5 cm) was found at initial endoscopy. In five patients recurrence was found
during follow-up with a mean interval of 6.6 months. Seven patients had a false-positive study due to benign lesions or swallowing
artefacts. In none of the patients with a normal PET study was tumour recurrence found during follow-up. The sensitivity and
specificity of FDG dual-head PET were 100% and 71%, respectively. It is concluded that FDG dual-head PET is highly sensitive
for the detection of local recurrence of laryngeal and hypopharyngeal carcinoma after radiotherapy. Some lesions were detected
with a mean interval of 6.6 months before histological confirmation. In patients suspected of having recurrent laryngeal or
hypopharyngeal cancer in whom FDG-PET is negative, endoscopy may be omitted for at least 6 months and possibly for up to 1
year.
Received 27 January and in revised form 15 March 1999 |
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| Keywords: | : Positron emission tomography Single-photon emission tomography Laryngeal carcinoma Local recurrence Fluorodeoxyglucose |
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