Positron emission tomography-computed tomography surveillance for the node-positive neck after chemoradiotherapy.

OBJECTIVES/HYPOTHESIS: To review our results with positron emission tomography and computed tomography fusion imaging (PET-CT) surveillance of the postchemoradiotherapy neck in patients with advanced head and neck squamous cell carcinoma.

STUDY DESIGN

Retrospective.

METHODS

Four hundred twenty-eight patients with advanced head and neck squamous cell carcinoma were treated with nonsurgical therapy from September 2002 to March 2007 and followed with post-treatment PET-CT surveillance of the neck. Fifty-two patients meeting inclusion criteria were analyzed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of PET-CT were determined.

RESULTS

Ten patients had a positive post-treatment PET-CT for residual neck disease, and 42 patients had negative scans. The NPV and PPV were 100% and 40%, respectively. The sensitivity, specificity, and accuracy were 100%, 87.5%, and 88%, respectively.

CONCLUSIONS

Planned neck dissection can be deferred with a negative post-treatment PET-CT. Assuming a complete response at the primary site and a negative PET-CT scan, there may be a role for serial PET-CT surveillance in patients with residual palpable cervical lymphadenopathy. Laryngoscope, 2009.