TY - JOUR
T1 - Preoperative 18F-FDG-PET/CT vs Contrast-Enhanced CT to Identify Regional Nodal Metastasis among Patients with Head and Neck Squamous Cell Carcinoma
AU - Cho, Joshua K.
AU - Ow, Thomas J.
AU - Lee, Andrew Y.
AU - Smith, Richard V.
AU - Schlecht, Nicolas F.
AU - Schiff, Bradley A.
AU - Tassler, Andrew B.
AU - Lin, Juan
AU - Moadel, Renee M.
AU - Valdivia, Ana
AU - Abraham, Tony
AU - Gulko, Edwin
AU - Neimark, Matthew
AU - Ustun, Berrin
AU - Bello, Jacqueline A.
AU - Shifteh, Keivan
N1 - Funding Information:
Funding source: Thomas J. Ow’s contribution was supported by NIH-NCI grant 2K12 CA132783-06 and by NIH/National Center for Advancing Translational Science (NCATS) Einstein-Montefiore CTSA Grant Number UL1TR001073. The manuscript content is solely the responsibility of the authors and do not necessarily represent the official views of the NIH.
Publisher Copyright:
© 2017, © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2017.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Objective: Our objective was to compare the accuracy of preoperative positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced CT (CECT) in detecting cervical nodal metastases in patients treated with neck dissection and to scrutinize the ability of each modality to determine nodal stage. Study Design: Case series with chart review. Setting: Montefiore Medical Center, Bronx, New York. Subjects and Methods: Patients who underwent neck dissection at our institution for primary treatment of head and neck squamous cell carcinoma (HNSCC) and had received preoperative PET/CT and CECT were included in this study. Imaging studies were reinterpreted by 3 specialists within the field and compared for interreader agreement. Concordance between radiology and histopathology was measured using neck levels and sides, along with patient nodal stage. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and agreement coefficients were calculated. Results: Seventy-three patients were included in the study. Sensitivity was 0.69 and 0.94 (level and side) for PET/CT vs 0.53 and 0.66 for CECT (P =.056, P =.001). Specificity was 0.86 and 0.56 for PET/CT vs 0.91 and 0.76 for CECT (P =.014, P =.024). No significant difference was found in overall accuracy (P =.33, P =.88). The overall agreement percentages between N stage called by imaging modality and pathology were 52% and 55% for PET/CT and CECT, respectively. Conclusion: No significant difference in sensitivity was found between PET/CT and CECT. CECT was found to have superior specificity compared with PET/CT. The information gleaned from each modality in the pretreatment evaluation of HNSCC appears to be complementary.
AB - Objective: Our objective was to compare the accuracy of preoperative positron emission tomography (PET)/computed tomography (CT) and contrast-enhanced CT (CECT) in detecting cervical nodal metastases in patients treated with neck dissection and to scrutinize the ability of each modality to determine nodal stage. Study Design: Case series with chart review. Setting: Montefiore Medical Center, Bronx, New York. Subjects and Methods: Patients who underwent neck dissection at our institution for primary treatment of head and neck squamous cell carcinoma (HNSCC) and had received preoperative PET/CT and CECT were included in this study. Imaging studies were reinterpreted by 3 specialists within the field and compared for interreader agreement. Concordance between radiology and histopathology was measured using neck levels and sides, along with patient nodal stage. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and agreement coefficients were calculated. Results: Seventy-three patients were included in the study. Sensitivity was 0.69 and 0.94 (level and side) for PET/CT vs 0.53 and 0.66 for CECT (P =.056, P =.001). Specificity was 0.86 and 0.56 for PET/CT vs 0.91 and 0.76 for CECT (P =.014, P =.024). No significant difference was found in overall accuracy (P =.33, P =.88). The overall agreement percentages between N stage called by imaging modality and pathology were 52% and 55% for PET/CT and CECT, respectively. Conclusion: No significant difference in sensitivity was found between PET/CT and CECT. CECT was found to have superior specificity compared with PET/CT. The information gleaned from each modality in the pretreatment evaluation of HNSCC appears to be complementary.
KW - PET/CT
KW - contrast-enhanced CT
KW - head and neck squamous cell carcinoma
KW - neck dissection
KW - nodal staging
KW - preoperative imaging
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U2 - 10.1177/0194599817703927
DO - 10.1177/0194599817703927
M3 - Article
C2 - 28608737
AN - SCOPUS:85029216220
VL - 157
SP - 439
EP - 447
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
SN - 0194-5998
IS - 3
ER -