Table of Contents
Journal of Oral Oncology
Volume 2015, Article ID 725482, 8 pages
Research Article

18F-FDG PET-CT in the Management of Patients Receiving Definitive Radiotherapy for Malignancies of the Head and Neck

1Diagnostic Imaging, Sutter Medical Group, 3161 L Street, Sacramento, CA 95814, USA
2University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA
3Radiological Associates of Sacramento Medical Group, 1500 Expo Parkway, Sacramento, CA 95815, USA
4Radiation Oncology Center, Sutter Medical Group, 2800 L Street, Sacramento, CA 95816, USA

Received 23 January 2015; Accepted 18 March 2015

Academic Editor: Peter Clarke

Copyright © 2015 Benjamin L. Franc et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The study investigated the utility and timing of 18F-FDG PET-CT to evaluate for residual/recurrent or metastatic HNC in patients treated with definitive intensity modulated radiation therapy (IMRT) with or without chemotherapy, planned with 18F-FDG PET-CT. The incidence and timing of locoregional recurrence, distant metastatic disease, new primary malignancies, and death were evaluated in 261 patients retrospectively. Findings were classified based on pathology or clinical follow-up and the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET-CT were determined overall as well as at the time of each 18F-FDG PET-CT. The overall accuracy for 18F-FDG PET in the detection of residual/recurrent malignancy or metastatic disease was 96.4%. Of those in whom cancer recurred locally, 57% were identified based on physical examination and other imaging findings and 43% were identified initially on 18F-FDG PET-CT surveillance imaging when no disease was evident clinically. 18F-FDG PET-CT has a high diagnostic capability of detecting residual/recurrent malignancy or malignant metastatic disease in patients with HNC following IMRT ± concurrent chemotherapy, supporting 18F- FDG PET-CT’s use to evaluate patients for recurrent malignancy in the post-IMRT period, even without clinical evidence of disease.