Recurrence of head and neck cancer after surgery or irradiation: prospective comparison of 2-deoxy-2-[F-18]fluoro-D-glucose PET and MR imaging diagnoses

Radiology. 1996 Jul;200(1):135-41. doi: 10.1148/radiology.200.1.8657901.


Purpose: To evaluate the diagnostic accuracy of positron emission tomography (PET) with administration of 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) relative to that of magnetic resonance (MR) imaging and/or computed tomography (CT) in recurrent head and neck cancers.

Materials and methods: Twelve adult patients (mean age, 63 years) with previously treated head and neck cancers and clinical suspicion of recurrence underwent FDG PET and MR imaging and/or CT. All images were blindly and independently interpreted without histopathologic findings (obtained within 1 week of imaging). The level of confidence in image interpretation was graded by using a five-point rating system (0 = definitely no recurrence to 4 = definite recurrence).

Results: Recurrence was confirmed in eight patients. With a rating of 4 as a positive finding, FDG PET yielded a sensitivity and specificity of 88% (seven of eight) and 100% (four of four), respectively; MR imaging and/or CT, 25% (two of eight) and 75% (three of four), respectively. Receiver-operating characteristic analysis showed significantly better diagnostic accuracy with FDG PET than with MR imaging and/or CT (area under curve = 0.96 vs 0.55, P < .03).

Conclusion: These data indicate that PET metabolic imaging, as compared with anatomic methods, has improved diagnostic accuracy for recurrent head and neck cancer.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Contrast Media*
  • Deoxyglucose / analogs & derivatives*
  • Female
  • Fluorodeoxyglucose F18
  • Head and Neck Neoplasms / diagnosis*
  • Head and Neck Neoplasms / diagnostic imaging
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery
  • Humans
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Mouth Neoplasms / diagnosis
  • Mouth Neoplasms / radiotherapy
  • Mouth Neoplasms / surgery
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Prospective Studies
  • ROC Curve
  • Sensitivity and Specificity
  • Tomography, Emission-Computed*
  • Tomography, X-Ray Computed


  • Contrast Media
  • Fluorodeoxyglucose F18
  • Deoxyglucose