The value of 18F-FDG-PET/CT imaging in oral cavity cancer patients following surgical reconstruction

Objective Follow‐up of patients with oral cavity squamous cell carcinoma (OCSCC) after tumor resection and reconstruction with tissue transfer is challenging. We compared contrast‐enhanced computed tomography (ceCT), 18F‐fluorodeoxyglucose‐positron emission tomography combined with noncontrast enhan...

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Bibliographic Details
Published in:The Laryngoscope 2015-08, Vol.125 (8), p.1861-1868
Main Authors: Müller, Julian, Hüllner, Martin, Strobel, Klaus, Huber, Gerhard F., Burger, Irene A., Haerle, Stephan K.
Format: Article
Language:English
Subjects:
18F-FDG-PET/CT
flap
follow-up
head and neck cancer
Metastasis
oral cavity
Physiology
reconstruction
Tomography
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Summary:Objective Follow‐up of patients with oral cavity squamous cell carcinoma (OCSCC) after tumor resection and reconstruction with tissue transfer is challenging. We compared contrast‐enhanced computed tomography (ceCT), 18F‐fluorodeoxyglucose‐positron emission tomography combined with noncontrast enhanced CT (18F‐FDG‐PET/CT), and 18F‐FDG‐PET combined with ceCT (18F‐FDG‐PET/ceCT) to determine the accuracy for detection of residual/recurrent disease after flap reconstruction for OCSCC. Study Design and Methods Two readers (R1, R2) retrospectively reviewed a total of 27 18F‐FDG‐PET/ceCT scans in patients after resection of stage II to IV OCSCC. They recorded the presence of local persistence/recurrence (LR), lymph node metastasis, or distant metastasis independently for ceCT, 18F‐FDG‐PET/CT, and 18F‐FDG‐PET/ceCT. Histological workup, imaging follow‐up, or clinical follow‐up served as the standard of reference. Maximum standardized uptake value (SUVmax) was evaluated to discriminate between physiological uptake and LR. Results The highest accuracy to detect LR was achieved with 18F‐FDG‐PET/ceCT, with a sensitivity/specificity of 88%/89% and 88%/79% for R1 and R2, respectively, as compared to ceCT with 75%/79% for R1 and 88%/68% for R2 and 18F‐FDG‐PET/CT with 88%/58% for both R1 and R2. Receiver‐operating‐characteristic analysis determined a cutoff value for SUVmax of 7.2, yielding a sensitivity and specificity of 75% and 94%, respectively, to distinguish LR from physiological 18F‐FDG uptake. Conclusion 18F‐FDG‐PET/ceCT seems to be the most reliable tool for locoregional surveillance of OCSCC patients after resection and reconstruction. Level of Evidence 4. Laryngoscope, 125:1861–1868, 2015
ISSN:0023-852X
1531-4995
DOI:10.1002/lary.25326