Abstract
Background: The accurate detection of distant metastases can facilitate appropriate treatment planning for patients with recurrent head and neck squamous cell carcinoma (HNSCC).
Objectives: We evaluated the role of 18F-FDG PET/CT for distant metastasis diagnosis and survival prediction in patients with recurrent HNSCC.
Materials and methods: This study included 95 consecutive patients with recurrent HNSCC and salvage treatments. McNemar’s test was used to compare the detection of distant metastasis at recurrence using 18F-FDG PET/CT and contrast-enhanced chest and neck CT, and bone scintigraphy.
Results: Thirty-two patients (34%) had distant metastases at recurrence. The sensitivity, specificity, accuracy, and positive and negative predictive values of 18F-FDG PET/CT for detecting chest and bone metastases were comparable to those of conventional imaging (p > .1). However, 18F-FDG PET/CT detected two additional distant metastatic lesions. After controlling for clinicopathological factors, a recurrent lesion with maximum standardized uptake value (SUVmax) >8.7 was identified as an independent predictor of poor overall survival (p = .001).
Conclusions and significance: 18F-FDG PET/CT or conventional imaging is comparable with regard to detecting distant metastases of recurrent HNSCC. However, 18F-FDG PET/CT may detect additional metastatic lesions in unusual distant sites and the recurrent lesion SUVmax may predict patient survival after salvage treatments.
Chinese abstract
背景:远处转移的准确检测可有助于复发性头颈部鳞状细胞癌(HNSCC)患者的适当治疗计划。
目的:我们评估了18F-FDG PET / CT对复发性HNSCC患者远处转移诊断和生存预测的作用。
材料与方法:本研究纳入95例复发HNSCC和抢救治疗的连续患者。 运用McNemar测试来比较使用18F-FDG PET / CT和反差增强的胸部和颈部CT以及骨闪烁扫描进行复发时远处转移的检测。
结果:32例患者(34%)复发时有远处转移。 18F-FDG PET / CT检测胸部和骨转移的敏感性、特异性、准确性以及阳性和阴性预测值与常规成像相当(p> .1)。然而, 18F-FDG PET / CT检测到另外两个远处转移病灶。在控制临床病理因素后, 具最大标准摄取值(SUVmax)> 8.7的复发病灶被确定为总生存率较低的独立预测因子(p = .001)。
结论和意义:18F-FDG PET / CT或常规成像在检测复发性HNSCC的远处转移方面具有可比性。然而, 18F-FDG PET / CT可以检测异常远端部位的其他转移性病变。复发性病变SUVmax可以预防挽救治疗后患者的存活率。
Disclosure statement
The authors have declared no conflict of interest.