ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

COSM 2012: Dr. Jonas Johnson Explores the Subtleties of PET/CT for Tumors

by Thomas R. Collins • May 9, 2012

  • Tweet
  • Email
Print-Friendly Version

You Might Also Like

No related posts.

Explore This Issue
May 2012
Dr. Johnson speaking on April 20.

PET combined with CT might be one of the most powerful imaging technologies available, but how effective it is in evaluating head and neck tumors and helping with treatment is not a cut-and-dried proposition, said Jonas Johnson, MD, professor and chair of otolaryngology at the University of Pittsburgh in his State of the Art Lecture.

Dr. Johnson gave the presentation at the 115th Annual Meeting of the Triological Society, held here on April 20 as part of the Combined Otolaryngology Spring Meetings.

He said that while those in his group at the University of Pittsburgh were “early adopters” of PET/CT in head and neck tumor treatment, he acknowledged that it’s a costly technology that requires understanding of the subtleties.

“It’s very sensitive and phenomenally expensive,” Dr. Johnson said. “The real problem is that while PET/CT is very reliable in terms of its negative predictive value, it is plagued by false positives.”

His address didn’t include any discussion of PET only, since by itself it gives “little or no anatomic detail.” “PET/CT is vastly better than PET alone,” he said.

He issued the caveat that neither the National Comprehensive Cancer Network (NCCN) Guidelines nor the Radiation Therapy Oncology Group (RTOG) includes any suggestions for the use of PET/CT. “If you use PET/CT, you’re out there a little in front of the rest,” he said.

Varying Benefits.

A main theme of Dr. Johnson’s remarks was that the benefits of PET/CT can be blurry. The value of PET/CT varies according to the size of the tumor, he said, discussing the case of a 4-mm metastasis.

“This is a very tiny microscopic metastasis,” he said. “We all understand that you cannot identify this volume of tumor with any modality currently available, other than by accident.”

As far as determining tumor staging, Dr. Johnson said the value of PET/CT might be dubious. “PET/CT has improved sensitivity, and the findings may influence therapeutic decisions, but frankly there’s no good cost-effective data,” he said. “We don’t have any yet and we need it…. PET/CT is inadequate to identify occult metastases in either the neck or distant (metastases).” But, he said, “the best available neck node data is from histology.”

Studies have shown that PET/CT detects about half of occult neck nodes and cannot replace the accuracy of a neck dissection, Dr. Johnson said. For identifying unknown primary tumors, studies have found that PET/CT has detected as many as 87 percent of them—which seems like “a lot,” Dr. Johnson said—down to 38 percent. The best meta-analysis suggests PET will identify one-third of these primary tumors, he said. “PET/CT, our most sensitive imaging modality, will not identify microscopic disease,” he added.

Chemoradiation Considerations

The use of PET/CT for surveillance in patients who’ve received chemoradiation treatment is one of the most difficult issues the technology presents, Dr. Johnson said. Generally, he said patients should get a PET/CT sometime around eight to 12 weeks after treatment.

Pages: 1 2 3 | Single Page

Filed Under: Career Development, Head and Neck, Practice Focus Tagged With: Combined Otolaryngology Spring Meetings, COSM, CT, PET, tumorsIssue: May 2012

You Might Also Like:

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • Vertigo in the Elderly: What Does It Mean?
    • Is Radiofrequency Ablation a Good Alternative to Surgery for Benign Thyroid Nodules? A Look at Benefits, Risks
    • What Happens to Medical Students Who Don’t Match?
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Rating Laryngopharyngeal Reflux Severity: How Do Two Common Instruments Compare?
    • Vertigo in the Elderly: What Does It Mean?
    • Neurogenic Cough Is Often a Diagnosis of Exclusion
    • Complications for When Physicians Change a Maiden Name
    • Smell and Taste Disorder Differences Seen Between Long-Term COVID-19 and non-COVID-19 Patients
    • The Triological Society is Growing in Ethnic and Gender Diversity as Well as Thesis Acceptance
    • No Persistent Postoperative Swallowing Dysfunction Following Pharyngeal Surgery in Patients with Obstructive Sleep Apnea
    • Do the Principles of Adult Learning Maximize Training Efficiency and Efficacy for Pediatric Otolaryngologists?
    • Prolonged Operative Time Associated with Multiple Adverse Outcomes in Endoscopic Sinonasal Surgery

Polls

Do you think that women have made large enough strides in otolaryngology leadership and gender equity?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use
  • Cookie Preferences

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2023 The Triological Society. All Rights Reserved.
ISSN 1559-4939