Diagnostik mittels 18F-FDG-PET nach Larynxorganerhalt durch prim�re Radiochemotherapie

Impact of FDG-PET to detect recurrence of head and neck squamous cell carcinoma

Objective

Prospectively evaluate the impact of fluorodeoxy-glucose-fluorine-18 positron emission tomography (FDG-PET) in the management of recurrence of advanced head and neck squa-mous cell carcinoma during the first year after treatment.

Study Design

Seventy patients were followed-up every 6 to 8 weeks during the first year after initial combined curative therapy. FDG-PET, together with conventional imaging and en-doscopy were performed systematically at 1 year (group A) or prompted earlier in case of clinically suspicious recurrence (group B). The referring physician evaluated the impact of FDG-PET on the patient's management. Another clinician checked the pertinence of decisions.

Results

FDG-PET had a therapeutic impact in 8 of 43 group A patients and in 16 of 27 group B patients; the overall rate was 34%. This change was pertinent in 5 of 8 and 14 of 16 cases, respectively. Overall pertinence rate of decisions was 90% versus 70% without FDG-PET.

Conclusions

FDG-PET had a significant overall therapeutic impact; the induced decisions were either pertinent or just led to “futile” noninvasive examinations. Systematic FDG-PET had a significantly lesser impact in comparison with FDG-PET motivated by clinical suspicion.