Evaluation of efficacy and clinical impact of positron emission tomography with 18F fluoro-deoxyglucose in patients with suspicion of recurrent head and neck cancer or distant metastases

Aims. To evaluate the efficacy and clinical impact of Positron Emission Tomography with FDG (FDG-PET) in patients with suspected recurrent head and neck cancer or distant metastases. Materials and methods. Sixty patients (12 women and 48 men) with suspicion of recurrent head and neck cancer and ambiguous conventional imaging modalities. In all patients a whole body scan was performed with FDG-PET in fasting patients following i.v. administration of 370-444 MBq FDG. The results were confirmed by histology and clinical evolution (follow-up period > 12 months) and imaging test. Results. Prevalence of recurrence was 66.6 %. FDG-PET was positive in 40/60 patients, with confirmation in 39 cases, and 18 were true negative (TN). We have found 2 false positive and 1 false negative. Overall sensitivity, specificity, PPV, NPV and accuracy were 97.5 %, 90 %, 95.12 %, 94.7 % and 95 %, respectively. FDG-PET changed the modality of treatment in 34 patients (clinical impact 56.6%) Conclusions. FDG-PET has high clinical impact in patients with suspicion of recurrent head and neck cancer, and should be incorporated in the diagnostic protocols before making a therapy decision.