Effectiveness of PET/CT in the preoperative evaluation of neck disease.

Authors

• Anthony Nguyen
• Adam Luginbuhl
• David Cognetti
• Katie Van Abel
• Voichita Bar-Ad
• Charles Intenzo
• William Keane
• Joseph Curry

Publication/Presentation Date

1-1-2014

Abstract

OBJECTIVES/HYPOTHESIS: To evaluate the utility of positron emission tomography (PET)/computed tomography (CT) for staging the neck in the preoperative setting by comparing it to both CT/magnetic resonance imaging (MRI) and pathologic staging.

STUDY DESIGN: Retrospective review.

METHODS: Seventy-one patients with initial diagnosis of head and neck squamous cell carcinoma having preoperative MR or CT imaging and PET/CT with subsequent bilateral neck dissection as part of primary treatment (142 neck dissections). Comparison of cervical nodal metastases based on three separate staging systems: preoperative CT and/or MRI scan, preoperative PET/CT, and pathology.

RESULTS: Both CT/MRI scans and PET/CT scans statistically predicted pathologic outcomes (P = 0.0001, P = 0.0001, respectively) using Chi square analysis. There was a statistically significant improvement in the prediction of true pathologic disease using PET/CT compared to CT and/or MRI alone (P = 0.005). In a subgroup analysis including only the contralateral neck, this significance persisted (P = 0.013). McNemar's test revealed that subsequent detection of bilateral neck disease by PET/CT scan was significantly superior to MRI or CT alone (P = 0.023).

CONCLUSION: In pathologically positive necks, PET/CT was statistically more reliable at identifying positive disease than CT or MRI alone. Furthermore, such a result is achieved without a statistically significant difference in false positivity between PET/CT and CT or MRI. This suggests that PET/CT positivity, despite negative clinical exam and CT/MRI findings, may be more likely to signify pathologic disease and require appropriate treatment.

Volume

124

Issue

1

First Page

159

Last Page

164

ISSN

1531-4995

Published In/Presented At

Nguyen, A., Luginbuhl, A., Cognetti, D., Van Abel, K., Bar-Ad, V., Intenzo, C., Keane, W., & Curry, J. (2014). Effectiveness of PET/CT in the preoperative evaluation of neck disease. The Laryngoscope, 124(1), 159–164. https://doi.org/10.1002/lary.24329

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

23901035

Department(s)

Administration and Leadership

Document Type

Article