Effect of 18F-fluorodeoxyglucose positron emission tomography on the management of patients with head and neck squamous cell carcinoma.

OBJECTIVE: Positron emission tomography (PET) has become a commonly used imaging modality for initial staging and for surveillance of patients with head and neck cancer. It is reported to be more sensitive and specific than computed tomography and magnetic resonance imaging in the detection of primary and metastatic tumours. The goal was to determine whether the information provided by PET alters the management of patients with head and neck squamous cell carcinoma.

MATERIALS AND METHODS: The records of patients who underwent PET as part of the initial staging evaluation or for posttreatment surveillance were reviewed.

RESULTS: PET was obtained in 29 patients as part of the initial staging evaluation and in 18 patients for posttreatment surveillance. In some patients, PET provided information beyond the information obtained from the routine workup and evaluation. This additional information altered the management of six patients (13%). Two of these patients were in the initial staging group and four patients were in the surveillance group. The management changes prompted by these results were unnecessary or erroneous in three of these six patients.

CONCLUSIONS: 18F-Fluorodeoxyglucose (FDG)-PET allows assessment of primary tumours, regional metastases, and distant metastases for the purpose of initial staging and for surveillance in previously treated patients. The information provided by the FDG-PET prompted further workup or altered the treatment plan of 13% of the patients. These changes in management were sometimes unnecessary.