Utility of positron emission tomography for the detection of disease in residual neck nodes after (chemo)radiotherapy in head and neck cancer

Head Neck. 2005 Mar;27(3):175-81. doi: 10.1002/hed.20130.


Background: This study evaluates the utility of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) in patients with a node-positive mucosal head and neck squamous cell carcinoma who achieved a complete response at the primary site but had a residual mass in the neck 8 weeks or more after definitive (chemo)radiotherapy.

Methods: Between October 1996 and July 2002, 39 eligible patients were identified. The reference PET scan was performed at a median of 12 weeks (range, 8-32 weeks) after treatment.

Results: PET showed no metabolic activity in the residual mass in 32 patients. Five of these patients had a neck dissection and were all pathologically negative. The remaining 27 patients were observed for a median of 34 months (range, 16-86 months), with only one locoregional failure. The negative predictive value of PET for viable disease in a residual anatomic abnormality was 97%.

Conclusion: Patients who have achieved a complete response at the primary site but have a residual abnormality in the neck that is PET negative approximately 12 weeks after treatment do not require neck dissection and can be safely observed. Head Neck

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / therapy*
  • Combined Modality Therapy
  • Female
  • Fluorodeoxyglucose F18
  • Head and Neck Neoplasms / drug therapy*
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm, Residual
  • Positron-Emission Tomography
  • Predictive Value of Tests
  • Radiopharmaceuticals
  • Radiotherapy Dosage


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18