The clinician's expectations from the use of positron emission tomography/computed tomography scanning in untreated and treated head and neck cancer patients.

PURPOSE OF REVIEW: We reviewed articles published in the last 2 years on the subject of positron emission tomography (PET)/computed tomography (CT) use in head and neck cancer patients. The focus is on helping otolaryngologists decide when to use PET/CT and how to apply it to head and neck cancer patient management.

RECENT FINDINGS: The main themes in the literature pertaining to PET/CT and head and neck cancer are use in untreated patients, evaluating early stage patients with N0 necks, use in cancer of unknown primary origin, detecting synchronous lesions and distant metastases, and use in previously treated patients.

SUMMARY: Evidence is mounting in both otolaryngology and radiation oncology literature to support PET/CT as the preferred imaging modality for certain patients with head and neck cancer. We should consider PET/CT's superior accuracy and ability to improve patient management. It is our opinion that this imaging modality increases the otolaryngologist's and radiation oncologist's confidence when treating head and neck cancer patients and leads to appropriate management changes. Certainly, additional prospective trials would help validate these opinions.