Clinical Significance of Postradiotherapy [18F]-Fluorodeoxyglucose Positron Emission Tomography Imaging in Management of Head-and-Neck Cancer-A Long-Term Outcome Report

Min Yao, Russell B Smith, Henry T. Hoffman, Gerry F. Funk, Minggen Lu, Yusuf Menda, Michael M. Graham, John M. Buatti

Research output: Contribution to journalArticle

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Abstract

Purpose: To determine the accuracy and prognostic significance of post-treatment [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) in head-and-neck squamous cell carcinoma after radiotherapy (RT). Methods and Materials: This was a retrospective study of 188 patients with head-and-neck squamous cell carcinoma who had undergone FDG-PET within 12 months after completing RT. All living patients had ≥1 year of follow-up after FDG-PET. All patients had undergone intensity-modulated RT, 128 with definitive and 60 with postoperative intensity-modulated RT. Results: For all patients, the median follow-up after RT completion was 32.6 months and after FDG-PET was 29.2 months. For the neck, 171 patients had negative FDG-PET findings. Of these results, two were falsely negative. Seventeen patients had positive FDG-PET findings, of which 12 were true-positive findings. The sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET in the assessment of the treatment response in the neck was 86%, 97%, 71%, and 99%, respectively. For the primary site, 151 patients had negative FDG-PET findings, of which two were falsely negative. Thirty-seven patients had positive FDG-PET findings, of which 12 were true-positive findings. The sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET in the assessment of the treatment response in the primary site was 86%, 86%, 32.4%, and 98.7%, respectively. Patients with positive post-RT PET findings had significantly worse 3-year overall survival and disease-free survival. Conclusion: The results of our study have shown that the findings of post-RT FDG-PET have a high negative predictive value and are a significant prognostic factor. It can provide guidance for the management of head-and-neck cancer after definitive treatment.

Original languageEnglish (US)
Pages (from-to)9-14
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume74
Issue number1
DOIs
StatePublished - May 1 2009

Fingerprint

Fluorodeoxyglucose F18
Head and Neck Neoplasms
Positron-Emission Tomography
positrons
tomography
cancer
radiation therapy
Radiotherapy
Intensity-Modulated Radiotherapy
Neck
Sensitivity and Specificity
sensitivity
Therapeutics
Disease-Free Survival
Retrospective Studies

Keywords

  • FDG-PET
  • Head-and-neck cancer
  • Radiotherapy
  • Treatment response
  • [F]-fluorodeoxyglucose positron emission tomography

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Clinical Significance of Postradiotherapy [18F]-Fluorodeoxyglucose Positron Emission Tomography Imaging in Management of Head-and-Neck Cancer-A Long-Term Outcome Report. / Yao, Min; Smith, Russell B; Hoffman, Henry T.; Funk, Gerry F.; Lu, Minggen; Menda, Yusuf; Graham, Michael M.; Buatti, John M.

In: International Journal of Radiation Oncology Biology Physics, Vol. 74, No. 1, 01.05.2009, p. 9-14.

Research output: Contribution to journalArticle

Yao, Min ; Smith, Russell B ; Hoffman, Henry T. ; Funk, Gerry F. ; Lu, Minggen ; Menda, Yusuf ; Graham, Michael M. ; Buatti, John M. / Clinical Significance of Postradiotherapy [18F]-Fluorodeoxyglucose Positron Emission Tomography Imaging in Management of Head-and-Neck Cancer-A Long-Term Outcome Report. In: International Journal of Radiation Oncology Biology Physics. 2009 ; Vol. 74, No. 1. pp. 9-14.
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abstract = "Purpose: To determine the accuracy and prognostic significance of post-treatment [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) in head-and-neck squamous cell carcinoma after radiotherapy (RT). Methods and Materials: This was a retrospective study of 188 patients with head-and-neck squamous cell carcinoma who had undergone FDG-PET within 12 months after completing RT. All living patients had ≥1 year of follow-up after FDG-PET. All patients had undergone intensity-modulated RT, 128 with definitive and 60 with postoperative intensity-modulated RT. Results: For all patients, the median follow-up after RT completion was 32.6 months and after FDG-PET was 29.2 months. For the neck, 171 patients had negative FDG-PET findings. Of these results, two were falsely negative. Seventeen patients had positive FDG-PET findings, of which 12 were true-positive findings. The sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET in the assessment of the treatment response in the neck was 86{\%}, 97{\%}, 71{\%}, and 99{\%}, respectively. For the primary site, 151 patients had negative FDG-PET findings, of which two were falsely negative. Thirty-seven patients had positive FDG-PET findings, of which 12 were true-positive findings. The sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET in the assessment of the treatment response in the primary site was 86{\%}, 86{\%}, 32.4{\%}, and 98.7{\%}, respectively. Patients with positive post-RT PET findings had significantly worse 3-year overall survival and disease-free survival. Conclusion: The results of our study have shown that the findings of post-RT FDG-PET have a high negative predictive value and are a significant prognostic factor. It can provide guidance for the management of head-and-neck cancer after definitive treatment.",
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AU - Smith, Russell B

AU - Hoffman, Henry T.

AU - Funk, Gerry F.

AU - Lu, Minggen

AU - Menda, Yusuf

AU - Graham, Michael M.

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AB - Purpose: To determine the accuracy and prognostic significance of post-treatment [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) in head-and-neck squamous cell carcinoma after radiotherapy (RT). Methods and Materials: This was a retrospective study of 188 patients with head-and-neck squamous cell carcinoma who had undergone FDG-PET within 12 months after completing RT. All living patients had ≥1 year of follow-up after FDG-PET. All patients had undergone intensity-modulated RT, 128 with definitive and 60 with postoperative intensity-modulated RT. Results: For all patients, the median follow-up after RT completion was 32.6 months and after FDG-PET was 29.2 months. For the neck, 171 patients had negative FDG-PET findings. Of these results, two were falsely negative. Seventeen patients had positive FDG-PET findings, of which 12 were true-positive findings. The sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET in the assessment of the treatment response in the neck was 86%, 97%, 71%, and 99%, respectively. For the primary site, 151 patients had negative FDG-PET findings, of which two were falsely negative. Thirty-seven patients had positive FDG-PET findings, of which 12 were true-positive findings. The sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET in the assessment of the treatment response in the primary site was 86%, 86%, 32.4%, and 98.7%, respectively. Patients with positive post-RT PET findings had significantly worse 3-year overall survival and disease-free survival. Conclusion: The results of our study have shown that the findings of post-RT FDG-PET have a high negative predictive value and are a significant prognostic factor. It can provide guidance for the management of head-and-neck cancer after definitive treatment.

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