FDG PET/CT in patients with head and neck squamous cell carcinoma after primary surgical resection with or without chemoradiation therapy

Mehdi Taghipour, Sara Sheikhbahaei, Rick Arthur Wray, Nishant Agrawal, Jeremy Richmon, Hyunseok Kang, Rathan M. Subramaniam

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this study was to assess the value of posttreatment FDG PET/CT in patients with squamous cell carcinoma of the head and neck (HNSCC) treated with primary surgical resection with or without adjuvant concurrent chemoradiotherapy. MATERIALS AND METHODS. A total of 98 HNSCC patients were treated with primary surgical resection and had undergone PET/CT within 6 months of treatment completion. The accuracy of the scans and the added value to clinical assessment and impact on management were established based on the clinical information before and after each scan. Overall survival of patients was estimated with Kaplan-Meier curves. RESULTS. Of the total 98 scans, 25 (25.5%) were interpreted as positive and 73 (74.5%) as negative. The sensitivity of posttreatment PET/CT was 80.0%; specificity, 89.5%; positive predictive value, 66.7%; negative predictive value, 94.4%; and accuracy, 87.5%. These scans were helpful in excluding tumor in 31.8% of patients with clinical suspicion of residual disease and identifying suspected residual disease in 13.2% of patients with no prior clinical suspicion. Multivariate regression analysis showed that tumor size, grade (p = 0.041), scan type (p = 0.002), and scan result (p = 0.005) were independent covariates associated with overall survival. Kaplan-Meier analysis showed a significant difference and association in overall survival between patients with a positive versus a negative posttherapy PET/CT scan result (hazard ratio, 5.65; 95% CI, 2.48-12.83; log rank Mantel-Cox p < 0.001). CONCLUSION. Posttreatment FDG PET/CT results had a high negative predictive value, added value to clinical assessment of 35% of patients, influenced subsequent management, and were associated with survival outcome of HNSCC patients treated with primary surgical resection.

Original languageEnglish (US)
Pages (from-to)1093-1100
Number of pages8
JournalAmerican Journal of Roentgenology
Volume206
Issue number5
DOIs
StatePublished - May 1 2016
Externally publishedYes

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Survival
Therapeutics
Adjuvant Chemoradiotherapy
Carcinoma, squamous cell of head and neck
Kaplan-Meier Estimate
Chemoradiotherapy
Neoplasms
Multivariate Analysis
Regression Analysis
Positron Emission Tomography Computed Tomography

Keywords

  • Head and neck
  • PET/CT
  • Postsurgical assessment
  • Squamous cell carcinoma
  • Surgical resection
  • Survival

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

FDG PET/CT in patients with head and neck squamous cell carcinoma after primary surgical resection with or without chemoradiation therapy. / Taghipour, Mehdi; Sheikhbahaei, Sara; Wray, Rick Arthur; Agrawal, Nishant; Richmon, Jeremy; Kang, Hyunseok; Subramaniam, Rathan M.

In: American Journal of Roentgenology, Vol. 206, No. 5, 01.05.2016, p. 1093-1100.

Research output: Contribution to journalArticle

Taghipour, Mehdi ; Sheikhbahaei, Sara ; Wray, Rick Arthur ; Agrawal, Nishant ; Richmon, Jeremy ; Kang, Hyunseok ; Subramaniam, Rathan M. / FDG PET/CT in patients with head and neck squamous cell carcinoma after primary surgical resection with or without chemoradiation therapy. In: American Journal of Roentgenology. 2016 ; Vol. 206, No. 5. pp. 1093-1100.
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abstract = "OBJECTIVE. The purpose of this study was to assess the value of posttreatment FDG PET/CT in patients with squamous cell carcinoma of the head and neck (HNSCC) treated with primary surgical resection with or without adjuvant concurrent chemoradiotherapy. MATERIALS AND METHODS. A total of 98 HNSCC patients were treated with primary surgical resection and had undergone PET/CT within 6 months of treatment completion. The accuracy of the scans and the added value to clinical assessment and impact on management were established based on the clinical information before and after each scan. Overall survival of patients was estimated with Kaplan-Meier curves. RESULTS. Of the total 98 scans, 25 (25.5{\%}) were interpreted as positive and 73 (74.5{\%}) as negative. The sensitivity of posttreatment PET/CT was 80.0{\%}; specificity, 89.5{\%}; positive predictive value, 66.7{\%}; negative predictive value, 94.4{\%}; and accuracy, 87.5{\%}. These scans were helpful in excluding tumor in 31.8{\%} of patients with clinical suspicion of residual disease and identifying suspected residual disease in 13.2{\%} of patients with no prior clinical suspicion. Multivariate regression analysis showed that tumor size, grade (p = 0.041), scan type (p = 0.002), and scan result (p = 0.005) were independent covariates associated with overall survival. Kaplan-Meier analysis showed a significant difference and association in overall survival between patients with a positive versus a negative posttherapy PET/CT scan result (hazard ratio, 5.65; 95{\%} CI, 2.48-12.83; log rank Mantel-Cox p < 0.001). CONCLUSION. Posttreatment FDG PET/CT results had a high negative predictive value, added value to clinical assessment of 35{\%} of patients, influenced subsequent management, and were associated with survival outcome of HNSCC patients treated with primary surgical resection.",
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AU - Taghipour, Mehdi

AU - Sheikhbahaei, Sara

AU - Wray, Rick Arthur

AU - Agrawal, Nishant

AU - Richmon, Jeremy

AU - Kang, Hyunseok

AU - Subramaniam, Rathan M.

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N2 - OBJECTIVE. The purpose of this study was to assess the value of posttreatment FDG PET/CT in patients with squamous cell carcinoma of the head and neck (HNSCC) treated with primary surgical resection with or without adjuvant concurrent chemoradiotherapy. MATERIALS AND METHODS. A total of 98 HNSCC patients were treated with primary surgical resection and had undergone PET/CT within 6 months of treatment completion. The accuracy of the scans and the added value to clinical assessment and impact on management were established based on the clinical information before and after each scan. Overall survival of patients was estimated with Kaplan-Meier curves. RESULTS. Of the total 98 scans, 25 (25.5%) were interpreted as positive and 73 (74.5%) as negative. The sensitivity of posttreatment PET/CT was 80.0%; specificity, 89.5%; positive predictive value, 66.7%; negative predictive value, 94.4%; and accuracy, 87.5%. These scans were helpful in excluding tumor in 31.8% of patients with clinical suspicion of residual disease and identifying suspected residual disease in 13.2% of patients with no prior clinical suspicion. Multivariate regression analysis showed that tumor size, grade (p = 0.041), scan type (p = 0.002), and scan result (p = 0.005) were independent covariates associated with overall survival. Kaplan-Meier analysis showed a significant difference and association in overall survival between patients with a positive versus a negative posttherapy PET/CT scan result (hazard ratio, 5.65; 95% CI, 2.48-12.83; log rank Mantel-Cox p < 0.001). CONCLUSION. Posttreatment FDG PET/CT results had a high negative predictive value, added value to clinical assessment of 35% of patients, influenced subsequent management, and were associated with survival outcome of HNSCC patients treated with primary surgical resection.

AB - OBJECTIVE. The purpose of this study was to assess the value of posttreatment FDG PET/CT in patients with squamous cell carcinoma of the head and neck (HNSCC) treated with primary surgical resection with or without adjuvant concurrent chemoradiotherapy. MATERIALS AND METHODS. A total of 98 HNSCC patients were treated with primary surgical resection and had undergone PET/CT within 6 months of treatment completion. The accuracy of the scans and the added value to clinical assessment and impact on management were established based on the clinical information before and after each scan. Overall survival of patients was estimated with Kaplan-Meier curves. RESULTS. Of the total 98 scans, 25 (25.5%) were interpreted as positive and 73 (74.5%) as negative. The sensitivity of posttreatment PET/CT was 80.0%; specificity, 89.5%; positive predictive value, 66.7%; negative predictive value, 94.4%; and accuracy, 87.5%. These scans were helpful in excluding tumor in 31.8% of patients with clinical suspicion of residual disease and identifying suspected residual disease in 13.2% of patients with no prior clinical suspicion. Multivariate regression analysis showed that tumor size, grade (p = 0.041), scan type (p = 0.002), and scan result (p = 0.005) were independent covariates associated with overall survival. Kaplan-Meier analysis showed a significant difference and association in overall survival between patients with a positive versus a negative posttherapy PET/CT scan result (hazard ratio, 5.65; 95% CI, 2.48-12.83; log rank Mantel-Cox p < 0.001). CONCLUSION. Posttreatment FDG PET/CT results had a high negative predictive value, added value to clinical assessment of 35% of patients, influenced subsequent management, and were associated with survival outcome of HNSCC patients treated with primary surgical resection.

KW - Head and neck

KW - PET/CT

KW - Postsurgical assessment

KW - Squamous cell carcinoma

KW - Surgical resection

KW - Survival

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