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(18)F-FDG-PET/CT for the detection of disease in patients with head and neck cancer treated with radiotherapy

OBJECTIVE: The aim of this study is to evaluate the diagnostic performance of FDG-PET/CT for the detection of residual disease after (chemo)radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) and to evaluate the prognostic value of the FDG-PET/CT findings. METHODS: Patients w...

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Autores principales: Helsen, Nils, Roothans, Dessie, Van Den Heuvel, Bert, Van den Wyngaert, Tim, Van den Weyngaert, Danielle, Carp, Laurens, Stroobants, Sigrid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542639/
https://www.ncbi.nlm.nih.gov/pubmed/28771540
http://dx.doi.org/10.1371/journal.pone.0182350
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author Helsen, Nils
Roothans, Dessie
Van Den Heuvel, Bert
Van den Wyngaert, Tim
Van den Weyngaert, Danielle
Carp, Laurens
Stroobants, Sigrid
author_facet Helsen, Nils
Roothans, Dessie
Van Den Heuvel, Bert
Van den Wyngaert, Tim
Van den Weyngaert, Danielle
Carp, Laurens
Stroobants, Sigrid
author_sort Helsen, Nils
collection PubMed
description OBJECTIVE: The aim of this study is to evaluate the diagnostic performance of FDG-PET/CT for the detection of residual disease after (chemo)radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) and to evaluate the prognostic value of the FDG-PET/CT findings. METHODS: Patients with HNSCC who underwent FDG-PET/CT after (chemo)radiotherapy were studied retrospectively. RESULTS: 104 FDG-PET/CT-scans were performed at a median of 13.2 weeks post-treatment (5.4–19.0 weeks). The diagnostic performance was time dependent with decreasing sensitivity and slightly increasing specificity over time. Sensitivity, specificity, PPV and NPV at 9 months after imaging were 91%, 87%, 77% and 95%, respectively. In a logistic regression model, the odds of a correct FDG-PET/CT increased with 33% every additional week after end of therapy (p = 0.01) and accuracy plateaued after 11 weeks (97%; p<0.001). A complete response on FDG-PET/CT was associated with an overall survival benefit (50.7 versus 10.3 months; p<0.001). Residual disease on FDG-PET/CT increased the risk of death 8-fold (p<0.001). CONCLUSION: FDG-PET/CT is able to detect residual disease after (chemo)radiotherapy, with an optimal time point for scanning between 11–12 weeks after therapy. However, a reevaluation is probably necessary 10–12 months after the FDG-PET/CT to detect late recurrences. In addition, FDG-PET/CT can guide decisions about neck dissection and identifies patients with poor prognosis.
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spelling pubmed-55426392017-08-12 (18)F-FDG-PET/CT for the detection of disease in patients with head and neck cancer treated with radiotherapy Helsen, Nils Roothans, Dessie Van Den Heuvel, Bert Van den Wyngaert, Tim Van den Weyngaert, Danielle Carp, Laurens Stroobants, Sigrid PLoS One Research Article OBJECTIVE: The aim of this study is to evaluate the diagnostic performance of FDG-PET/CT for the detection of residual disease after (chemo)radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) and to evaluate the prognostic value of the FDG-PET/CT findings. METHODS: Patients with HNSCC who underwent FDG-PET/CT after (chemo)radiotherapy were studied retrospectively. RESULTS: 104 FDG-PET/CT-scans were performed at a median of 13.2 weeks post-treatment (5.4–19.0 weeks). The diagnostic performance was time dependent with decreasing sensitivity and slightly increasing specificity over time. Sensitivity, specificity, PPV and NPV at 9 months after imaging were 91%, 87%, 77% and 95%, respectively. In a logistic regression model, the odds of a correct FDG-PET/CT increased with 33% every additional week after end of therapy (p = 0.01) and accuracy plateaued after 11 weeks (97%; p<0.001). A complete response on FDG-PET/CT was associated with an overall survival benefit (50.7 versus 10.3 months; p<0.001). Residual disease on FDG-PET/CT increased the risk of death 8-fold (p<0.001). CONCLUSION: FDG-PET/CT is able to detect residual disease after (chemo)radiotherapy, with an optimal time point for scanning between 11–12 weeks after therapy. However, a reevaluation is probably necessary 10–12 months after the FDG-PET/CT to detect late recurrences. In addition, FDG-PET/CT can guide decisions about neck dissection and identifies patients with poor prognosis. Public Library of Science 2017-08-03 /pmc/articles/PMC5542639/ /pubmed/28771540 http://dx.doi.org/10.1371/journal.pone.0182350 Text en © 2017 Helsen et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Helsen, Nils
Roothans, Dessie
Van Den Heuvel, Bert
Van den Wyngaert, Tim
Van den Weyngaert, Danielle
Carp, Laurens
Stroobants, Sigrid
(18)F-FDG-PET/CT for the detection of disease in patients with head and neck cancer treated with radiotherapy
title (18)F-FDG-PET/CT for the detection of disease in patients with head and neck cancer treated with radiotherapy
title_full (18)F-FDG-PET/CT for the detection of disease in patients with head and neck cancer treated with radiotherapy
title_fullStr (18)F-FDG-PET/CT for the detection of disease in patients with head and neck cancer treated with radiotherapy
title_full_unstemmed (18)F-FDG-PET/CT for the detection of disease in patients with head and neck cancer treated with radiotherapy
title_short (18)F-FDG-PET/CT for the detection of disease in patients with head and neck cancer treated with radiotherapy
title_sort (18)f-fdg-pet/ct for the detection of disease in patients with head and neck cancer treated with radiotherapy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542639/
https://www.ncbi.nlm.nih.gov/pubmed/28771540
http://dx.doi.org/10.1371/journal.pone.0182350
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