TY - JOUR
T1 - Diagnostic accuracy of follow-up FDG PET or PET/CT in patients with head and neck cancer after definitive treatment
T2 - A systematic review and meta-analysis
AU - Sheikhbahaei, Sara
AU - Taghipour, Mehdi
AU - Ahmad, Rubina
AU - Fakhry, Carole
AU - Kiess, Ana P.
AU - Chung, Christine H.
AU - Subramaniam, Rathan M.
N1 - Publisher Copyright:
© American Roentgen Ray Society.
PY - 2015/9/1
Y1 - 2015/9/1
N2 - OBJECTIVE. The purpose of this study was to assess the diagnostic performance of FDG PET or PET/CT for detection of local, regional, and distant recurrences in the follow-up of patients with head and neck cancer who underwent definitive treatment. MATERIALS AND METHODS. A systematic search was performed in MEDLINE and Cochrane Library (updated September 2014) to identify relevant published studies. Studies investigating the accuracy of FDG PET/CT that were performed at least 4 months after therapy were included. Two authors independently screened all retrieved articles, selected studies that met the inclusion criteria, and extracted the data. Histopathologic confirmation or clinical follow-up of at least 6 month (or both) was considered as the reference standard. RESULTS. Twenty-three studies constituting a total of 2247 FDG PET/CT examinations met our inclusion criteria. The pooled sensitivity and specificity of follow-up PET/CT for detection of recurrence were 0.92 (95% CI, 0.90-0.94), and 0.87 (95% CI, 0.82-0.91), respectively. The pooled sensitivity and specificity of scans performed 4-12 months after treatment were 0.95 (95% CI, 0.91-0.97) and 0.78 (95% CI, 0.70-0.84), respectively. Similar estimates for scans performed at or more than 12 months after treatment were 0.92 (95% CI, 0.85-0.96) and 0.91 (95% CI, 0.78-0.96), respectively. The overall accuracy of FDG PET/CT in detecting recurrence is higher in patients without suspicion of recurrence before the scan compared with the patients with suspected recurrence. CONCLUSION. The high diagnostic performance of FDG PET/CT in detecting recurrence in curatively treated patients with head and neck cancer supports its use in clinical practice for patient follow-up. Further studies are needed to evaluate the prognostic utility of PET/CT in the follow-up of head and neck cancer.
AB - OBJECTIVE. The purpose of this study was to assess the diagnostic performance of FDG PET or PET/CT for detection of local, regional, and distant recurrences in the follow-up of patients with head and neck cancer who underwent definitive treatment. MATERIALS AND METHODS. A systematic search was performed in MEDLINE and Cochrane Library (updated September 2014) to identify relevant published studies. Studies investigating the accuracy of FDG PET/CT that were performed at least 4 months after therapy were included. Two authors independently screened all retrieved articles, selected studies that met the inclusion criteria, and extracted the data. Histopathologic confirmation or clinical follow-up of at least 6 month (or both) was considered as the reference standard. RESULTS. Twenty-three studies constituting a total of 2247 FDG PET/CT examinations met our inclusion criteria. The pooled sensitivity and specificity of follow-up PET/CT for detection of recurrence were 0.92 (95% CI, 0.90-0.94), and 0.87 (95% CI, 0.82-0.91), respectively. The pooled sensitivity and specificity of scans performed 4-12 months after treatment were 0.95 (95% CI, 0.91-0.97) and 0.78 (95% CI, 0.70-0.84), respectively. Similar estimates for scans performed at or more than 12 months after treatment were 0.92 (95% CI, 0.85-0.96) and 0.91 (95% CI, 0.78-0.96), respectively. The overall accuracy of FDG PET/CT in detecting recurrence is higher in patients without suspicion of recurrence before the scan compared with the patients with suspected recurrence. CONCLUSION. The high diagnostic performance of FDG PET/CT in detecting recurrence in curatively treated patients with head and neck cancer supports its use in clinical practice for patient follow-up. Further studies are needed to evaluate the prognostic utility of PET/CT in the follow-up of head and neck cancer.
KW - FDG PET
KW - Follow-up
KW - Head and neck neoplasm
KW - Meta-analysis
KW - PET/CT
KW - Recurrence
KW - Sensitivity and specificity
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U2 - 10.2214/AJR.14.14166
DO - 10.2214/AJR.14.14166
M3 - Review article
C2 - 26295652
AN - SCOPUS:84942673494
SN - 0361-803X
VL - 205
SP - 629
EP - 639
JO - American Journal of Roentgenology
JF - American Journal of Roentgenology
IS - 3
ER -