Improvement in the detection of locoregional recurrence in head and neck malignancies: F-18 fluorodeoxyglucose-positron emission tomography/computed tomography compared to high-resolution contrast-enhanced computed tomography and endoscopic examination

Laryngoscope. 2013 Nov;123(11):2664-9. doi: 10.1002/lary.24077. Epub 2013 Apr 1.


Objectives/hypothesis: To compare the diagnostic efficacy of positron emission tomography (PET) with F-18 fluorodeoxyglucose (FDG-PET)/computed tomography (CT) to that of contrast-enhanced high-resolution CT (HRCT) and assess the value of a combinatorial approach in detection of recurrent squamous cell cancer of the head and neck (HNC) and to assess the efficacy of FDG-PET/CT with and without HRCT in comparison to standard-of-care follow-up--physical examination (PE) and endoscopy (E)--in determination of locally recurrent HNC.

Study design: Retrospective study.

Methods: A total of 103 patients with HNC underwent FDG-PET/CT and neck HRCT. There were two groups of patients: Group A had an FDG-PET study acquired with low-dose CT, and group B had an FDG-PET study acquired with HRCT. The PET data obtained with or without HRCT were compared on a lesion and patient basis with the results of the PE/E.

Results: On a lesion basis, both groups combined had higher sensitivity and negative predictive value (NPV) than the HRCT. Specificity and positive predictive value (PPV) for group B were higher than for group A. On a patient basis, both groups combined had a higher sensitivity and NPV than PE/E, respectively, although specificity of PE/E was higher than that of either group. PET data obtained with either protocol directly influenced treatment.

Conclusions: HRCT increases the specificity and PPV of PET/CT when acquired simultaneously with PET. FDG-PET/CT acquired with either LDCT or HRCT has higher accuracy than HRCT alone and increases the sensitivity and NPV of PE/E.

Keywords: F-18 fluorodeoxyglucose positron emission tomography; computed tomography; neck high-resolution computed tomography; recurrent squamous cell cancer of the head and neck.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Contrast Media*
  • Endoscopy*
  • Female
  • Fluorodeoxyglucose F18*
  • Head and Neck Neoplasms / diagnostic imaging*
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging*
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Physical Examination*
  • Positron-Emission Tomography*
  • Radiopharmaceuticals*
  • Retrospective Studies
  • Tomography, Spiral Computed
  • Tomography, X-Ray Computed* / methods


  • Contrast Media
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18