The use of positron emission tomography scanning in occult and recurrent head and neck cancer

Positron Emission Tomography (PET scan) has been effectively utilized in the last 6 years as a diagnostic modality of high sensitivity in the detection of locoregional head and neck cancer. We report our experience on 29 patients with whole body high resolution fluorodeoxyglucose PET scan in the detection of occult locoregional head and neck malignancy as well as that of distant metastases. In the detection of primary or recurrent local disease PET scan was equivalent in sensitivity with conventional imaging (computed tomography plus magnetic resonance) (87% vs 88%), the specificity of PET scan was higher (80% vs 50%). In the detection of regional disease PET scan was superior to conventional imaging both as a sensitive and specific tool (sensitivity: 80% vs 57% and specificity of 85% vs 77%). In the detection of distant metastasis from the head and neck PET scan had a sensitivity of 90% and specificity of 94%. We conclude that PET scan may be advantageous to conventional imaging for the detection of locoregional primary or recurrent head and neck malignancy. PET scan is the optimal modality in the detection of distant metastases from a head and neck site.