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Annals of Oncology Advance Access originally published online on August 22, 2007
Annals of Oncology 2007 18(10):1698-1703; doi:10.1093/annonc/mdm270
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© 2007 European Society for Medical Oncology

head and neck cancer

Combined 18F-fluorodeoxyglucose-positron emission tomography and computed tomography as a primary screening method for detecting second primary cancers and distant metastases in patients with head and neck cancer

S. Y. Kim1, J.-L. Roh1,*, N.-K. Yeo1, J. S. Kim2, J. H. Lee3, S.-H. Choi1 and S. Y. Nam1

1 Department of Otolaryngology
2 Department of Nuclear Medicine
3 Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

* Correspondence to: Dr. J.-L. Roh, Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea. Tel: +82–2–3010–965; Fax: +82–2–489–2773; E-mail address: rohjl{at}amc.seoul.kr

Background: The aim of this study was to evaluate the ability of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) to detect second primary cancers and distant metastases in patients with head and neck cancer (HNC).

Patients and methods: Patients with previous untreated HNC, between 2004 and 2005, underwent head and neck CT and whole-body FDG-PET/CT, before and at fixed intervals after therapy, for staging and detection of second primary cancers and distant metastases. Patients with malignant or equivocal findings on FDG-PET/CT underwent further imaging, endoscopy and/or biopsy.

Results: Of the 349 eligible patients (267 men and 82 women), 14 (4.0%) had second primary cancers and 26 (7.4%) had distant metastases at initial staging or during mean follow-up of 15 months after treatment. FDG-PET/CT correctly identified second cancers or distant metastases in 39 of these 40 patients; there was one false negative and 23 false positive FDG-PET/CT results. Therefore, FDG-PET/CT had a sensitivity of 97.5%, a specificity of 92.6%, a positive predictive value of 62.9% and a negative predictive value of 99.7% in detecting second primary cancers and distant metastases.

Conclusion: Combined FDG-PET/CT is useful as a primary method for detecting second cancers and distant metastases in patients with HNC.

Key words: head and neck cancers, second primary cancers, distant metastasis, FDG-PET/CT

Received for publication March 9, 2007. Revision received May 1, 2007. Accepted for publication May 2, 2007.


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