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

PET Not Ready for Routine Management of Head and Neck Cancer

by Ed Susman • April 1, 2006

  • Tweet
  • Email
Print-Friendly Version

NAPLES, Fla.-The use of positron emission tomography (PET) is not sensitive enough to warrant routine use in post-curative chemoradiation therapy diagnosis of patients with node-positive head and neck cancer, according to researchers in the field.

You Might Also Like

  • PET/CT Useful for Head and Neck Cancers, with Limitations
  • HN Cancer Patients with Negative Imaging History Derive Limited Benefit from Subsequent PET-CT
  • Survival for Advanced Head, Neck Cancer Improvements May Be Related to PET
  • PET-Directed Management of Node-Positive Head and Neck Cancers
Explore This Issue
April 2006

At least two recent studies have shown that after chemoradiotherapy, neck dissections indicate that as many as 38% of patients have residual cervical metastatic disease.

The use of computer-assisted tomography (CT) in evaluating patients following the node-positive neck after organ preservation therapy has been unreliable, said Victoria S. Brkovich, MD, a resident in the Department of Otolaryngology at the University of Texas Health Science Center at San Antonio.

In delivering the G. Slaughter Fitz-Hugh Resident Research Award here at the Southern Section Meeting of the Triological Society, Dr. Brkovich said that studies with CT show that the images have a sensitivity of 85%, specificity of 24%, and positive predictive value of 40%.

With those shortcomings in mind, some researchers have looked to PET imaging to predict residual cervical metastatic disease after treatment with chemoradiotherapy.

A significant number of head and neck squamous cell carcinoma with N2 or N3 disease harbor residual metastases despite an apparent clinical response. – -Christine Gourin, MD

Why Use PET to Detect Cancer

She explained that when patients are injected with the positron-emitting radionucleotide 18-fluorodeoxyglucose (FDG), the radionucleotide is taken up in cells by glucose transporters. Its distribution is a measure of glucose metabolism.

Because neoplasms generally demonstrate increased glucose metabolism, the uptake of 18-FDG PET may detect and localize a viable tumor.

In her study, Dr. Brkovich recruited 21 patients in a prospective case series in 2004 and 2005 who had undergone curative surgery and chemoradiation for squamous cell cancer of the head and neck. To be included in the study, patients had to have had biopsy-proven squamous cell carcinoma of the upper aerodigestive tract, node-positive neck disease, completion of the chemotherapy or chemoradiation protocol, a complete response at the tumor site, a post-treatment PET scan, and salvage neck dissection.

The sensitivity, specificity, and positive and negative predictive values were calculated based on the comparison of the PET scan result and the histopathological result of the corresponding neck dissection sample, she said.

Results Lacking Specificity, Sensitivity

The histopathological report found four neck dissections were positive for residual squamous cell carcinoma and the other 17 specimens were negative.

Dr. Brkovich said there were three true positive PET studies and one false negative PET study among the four specimen-positive findings. There were 11 true negative PET studies and 6 false positive PET studies.

Pages: 1 2 3 | Single Page

Filed Under: Departments, Head and Neck, Medical Education, Practice Focus, Tech Talk Tagged With: cancer, carcinoma, CT, diagnosis, Imaging, PET, radiation, research, technologyIssue: April 2006

You Might Also Like:

  • PET/CT Useful for Head and Neck Cancers, with Limitations
  • HN Cancer Patients with Negative Imaging History Derive Limited Benefit from Subsequent PET-CT
  • Survival for Advanced Head, Neck Cancer Improvements May Be Related to PET
  • PET-Directed Management of Node-Positive Head and Neck Cancers

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
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Weaning Patients Off of PPIs
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Did You Receive COVID-19 Relief? Here Are Reporting Considerations for 2021
    • Otolaryngology Experts Share Best Practices in Five Areas
    • How Climate Change May Be Affecting Sleep Patterns for Adults and Children
    • Laryngologists Discuss Tough Tracheostomy Choices During COVID-19 Era
    • Head and Neck Cancer: Experts Discuss How to Improve Surgery Quality and Value

Polls

Did you receive funding from the CARES Act or Paycheck Protection Program?

View Results

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

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

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.