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Clin. Nucl. Med., Apr 01 2025, 50 (4) | https://doi.org/10.1097/RLU.0000000000005639
Diagnostic Value of Surveillance 18F-FDG PET/CT in Head and Neck Squamous Cell Carcinoma After Curative Therapy
Whi, Wonseok MD, PhD∗; Moon, Seung Hwan MD, PhD∗; Oh, Dongryul MD, PhD†; Chung, Man Ki MD, PhD‡; Jeong, Han-Sin MD, PhD‡; Ahn, Myung Ju MD, PhD§; Choi, Joon Young MD, PhD∗
From the ∗Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
†Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
‡Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
§Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
W.W. and S.H.M. both contributed equally to this work.
Correspondence to: Joon Young Choi, MD, PhD
From the ∗Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
†Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
‡Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
§Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
W.W. and S.H.M. both contributed equally to this work.
Correspondence to: Joon Young Choi, MD, PhD
Abstract
Purpose: This study aimed to evaluate the diagnostic performance of surveillance FDG PET/CT for detection of clinically unexpected recurrent disease or second primary malignancy in head and neck squamous cell carcinoma (HNSCC) patients who underwent curative treatment.
Patients and methods: We conducted a retrospective analysis of 739 consecutive patients with HNSCC who underwent 2396 surveillance FDG PET/CT scans. Surveillance FDG PET/CT scans were defined as routine follow-up scans after curative therapy without suspicion of recurrence. The diagnostic performance of FDG PET/CT was evaluated based on sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.
Results: Of the 2396 surveillance FDG PET/CT scans, 119 (5.0%) showed positive findings, with 93 (78.1%) confirmed as true-positives. True-positive detections included locoregional metastases, distant metastases, or second primary malignancies. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.9%, 98.9%, 78.2%, 99.9%, and 98.8%, respectively. The incidence of recurrence was significantly greater in patients initially diagnosed with stage IVA disease (P = 0.03) and for which 5 or more years had elapsed since treatment (P < 0.001) than in other subgroups. However, no significant differences in diagnostic performance were observed across subgroups divided by tumor location, disease stage, treatment modality, or time since treatment.
Conclusions: Surveillance FDG PET/CT showed excellent diagnostic performance for detection of clinically unexpected recurrent disease or second primary malignancies in patients with HNSCC after curative therapy. The frequency and duration of surveillance could be adjusted based on the initial disease stage to optimize early detection and intervention.
Patients and methods: We conducted a retrospective analysis of 739 consecutive patients with HNSCC who underwent 2396 surveillance FDG PET/CT scans. Surveillance FDG PET/CT scans were defined as routine follow-up scans after curative therapy without suspicion of recurrence. The diagnostic performance of FDG PET/CT was evaluated based on sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.
Results: Of the 2396 surveillance FDG PET/CT scans, 119 (5.0%) showed positive findings, with 93 (78.1%) confirmed as true-positives. True-positive detections included locoregional metastases, distant metastases, or second primary malignancies. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.9%, 98.9%, 78.2%, 99.9%, and 98.8%, respectively. The incidence of recurrence was significantly greater in patients initially diagnosed with stage IVA disease (P = 0.03) and for which 5 or more years had elapsed since treatment (P < 0.001) than in other subgroups. However, no significant differences in diagnostic performance were observed across subgroups divided by tumor location, disease stage, treatment modality, or time since treatment.
Conclusions: Surveillance FDG PET/CT showed excellent diagnostic performance for detection of clinically unexpected recurrent disease or second primary malignancies in patients with HNSCC after curative therapy. The frequency and duration of surveillance could be adjusted based on the initial disease stage to optimize early detection and intervention.
논문정보
- Research article
- 2025년 04월 (BRIC 등록일 2025-03-04)
- 국내 연구진
- 의약학 > 응용의학
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