The role of FDG-PET/CT imaging in head and neck malignant conditions: Impact on diagnostic accuracy and patient care

BACKGROUND: To assess the value of positron emission tomography/computed tomography (PET/CT) with F-18-Fluorodeoxyglucose (FDG) in patients with head and neck carcinoma as compared with PET and conventional imaging alone, and to assess the impact of PET/CT on further clinical management. STUDY DESIGN: Prospective nonrandomized study. SETTING: Ninety patients with head and neck tumors had 107 PET/CT examinations. RESULTS: The study analysis showed that PET/CT had a sensitivity of 89%, specificity 95%, PPV 94%, NPV 90%, and accuracy of 92%. PET/CT altered management in 51 patients (56%). PET/CT eliminated the need for previously planned diagnostic procedures in 24 patients, induced a change in the planned therapeutic approach in 21 patients and guided biopsy in 6 patients. CONCLUSIONS: PET/CT is an imaging modality with high diagnostic performance in the assessment of head and neck cancer, and induced a change in further clinical management in more than half of the study population. (C) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.