Logo image
Staging of Head and Neck Squamous Cell Cancer with Extended-Field FDG-PET
Journal article   Peer reviewed

Staging of Head and Neck Squamous Cell Cancer with Extended-Field FDG-PET

David L. Schwartz, Joseph Rajendran, Bevan Yueh, Marc Coltrera, Yoshimi Anzai, Kenneth Krohn and Janet Eary
Archives of otolaryngology--head & neck surgery, Vol.129(11), pp.1173-1178
11/01/2003
DOI: 10.1001/archotol.129.11.1173
PMID: 14623746

View Online

Abstract

Background Accurate baseline staging is necessary to appropriately treat head and neck squamous cell carcinoma. [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) is valuable for locoregional staging of primary head and neck disease. The effectiveness of FDG-PET for the detection of distant metastatic or synchronous disease remains unproven. Objective To investigate the utility of FDG-PET extended into the abdomen (extended-field FDG-PET) for wide-field staging of head and neck tumors. Methods This is a prospective institutional study of 35 consecutive patients diagnosed with American Joint Committee on Cancer (AJCC)-defined stage II-IV squamous cell carcinoma of the oral cavity, oropharynx, or larynx between September 2000 and June 2002. Thirty-three patients (94%) were eligible for analysis. All patients were routinely staged with chest radiography, liver function tests, and extended-field FDG-PET. Chest or abdominal computed tomographic scans were used as corroborative studies and were obtained only when one of the above tests indicated distant disease. Results Of 33 patients, 7 (21%) had evidence of distant disease by extend-field FDG-PET—4 with metastases and 3 with synchronous primary cancers of the aerodigestive tract. [F-18]-fluorodeoxyglucose PET detected hepatic, bone, gastrointestinal, and mediastinal disease not identified by chest radiography or liver function tests. Two of the 7 patients with FDG-avid distant disease had false-negative staging by all other tests, including computed tomography. Conclusions Extended-field FDG-PET is feasible and may improve staging of primary head and neck squamous cell carcinoma. Use of staging FDG-PET must be explicitly described in reports from centers engaged in prospective research to facilitate comparison with historical results.

Details

Metrics

Logo image