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Prognostic Value of FDG-PET in patients with oropharyngeal carcinoma treated with concurrent chemoradiotherapy.

Enomoto K, Inohara H, Higuchi I, Hamada K, Tomiyama Y, Kubo T, Hatazawa J - Mol Imaging Biol (2008)

Bottom Line: The prognostic performance of post-CRT PET and CT for recurrence was compared.Patients with positive post-CRT PET exhibited significantly lower 2-year cause-specific survival and disease-free survival (50% vs. 91%, P < 0.05 and 0% vs. 83%, P < 0.0001); however, patients with positive post-CRT CT did not exhibit any significant difference (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070).The prognostic accuracy of post-CRT PET is superior to that of CT.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Osaka University School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. keisuke.enomoto@tracer.med.osaka-u.ac.jp

ABSTRACT

Purpose: The purpose of this study was to evaluate the predictive value of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) following concurrent chemoradiotherapy (CRT) on survival in patients with carcinoma of the oropharynx (OPC).

Methods: Eighteen patients with primary OPC who underwent PET pre- and post-CRT were evaluated prospectively for survival. The prognostic performance of post-CRT PET and CT for recurrence was compared.

Results: Patients with positive post-CRT PET exhibited significantly lower 2-year cause-specific survival and disease-free survival (50% vs. 91%, P < 0.05 and 0% vs. 83%, P < 0.0001); however, patients with positive post-CRT CT did not exhibit any significant difference (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070). Other factors, such as clinical and pre-CRT PET variables, also did not indicate any significant difference. The accuracy of prediction of residual and local recurrence for post-CRT PET and CT (local%/regional%) was 83%/94% and 83%/78%, respectively.

Conclusion: OPC patients with positive post-CRT PET exhibit poor survival. The prognostic accuracy of post-CRT PET is superior to that of CT. The results of post-CRT FDG-PET should be included in the management of the OPC patients.

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Related in: MedlinePlus

Discrepancy between PET and CT findings. A 48-year-old female with OPC of the superior wall relapsed in the right parapharyngeal site about 2 months later. A contrast-enhanced CT resulted in false-negative findings. a Post-CRT PET correctly identified the right parapharyngeal metastasis (arrow). b Post-CRT axial CT scan showed an 8 × 7 mm lymph node that was enhanced homogeneously (arrow) with no evidence of metastasis.
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Fig4: Discrepancy between PET and CT findings. A 48-year-old female with OPC of the superior wall relapsed in the right parapharyngeal site about 2 months later. A contrast-enhanced CT resulted in false-negative findings. a Post-CRT PET correctly identified the right parapharyngeal metastasis (arrow). b Post-CRT axial CT scan showed an 8 × 7 mm lymph node that was enhanced homogeneously (arrow) with no evidence of metastasis.

Mentions: The prognostic performance for post-CRT FDG-PET and CT is summarized in Table 2. Comparing post-CRT FDG-PET and CT findings for the assessment of recurrence at the primary site (local recurrence), both imaging modalities did not exhibit any false-positive results and three false-negative findings in four cases. However, the positive findings were found in different cases (Fig. 3). For those patients with lymph node metastases (regional recurrence), contrast-enhanced CT was false-positive in two cases, compared with no false-positive FDG-PET findings. CT was false-negative in two cases, compared with one case for FDG-PET (Fig. 4). The overall accuracy of post-CRT FDG-PET and CT in evaluating local recurrence was 83% and 83% respectively, and 94% versus 78% for regional recurrence.Fig. 3


Prognostic Value of FDG-PET in patients with oropharyngeal carcinoma treated with concurrent chemoradiotherapy.

Enomoto K, Inohara H, Higuchi I, Hamada K, Tomiyama Y, Kubo T, Hatazawa J - Mol Imaging Biol (2008)

Discrepancy between PET and CT findings. A 48-year-old female with OPC of the superior wall relapsed in the right parapharyngeal site about 2 months later. A contrast-enhanced CT resulted in false-negative findings. a Post-CRT PET correctly identified the right parapharyngeal metastasis (arrow). b Post-CRT axial CT scan showed an 8 × 7 mm lymph node that was enhanced homogeneously (arrow) with no evidence of metastasis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2480511&req=5

Fig4: Discrepancy between PET and CT findings. A 48-year-old female with OPC of the superior wall relapsed in the right parapharyngeal site about 2 months later. A contrast-enhanced CT resulted in false-negative findings. a Post-CRT PET correctly identified the right parapharyngeal metastasis (arrow). b Post-CRT axial CT scan showed an 8 × 7 mm lymph node that was enhanced homogeneously (arrow) with no evidence of metastasis.
Mentions: The prognostic performance for post-CRT FDG-PET and CT is summarized in Table 2. Comparing post-CRT FDG-PET and CT findings for the assessment of recurrence at the primary site (local recurrence), both imaging modalities did not exhibit any false-positive results and three false-negative findings in four cases. However, the positive findings were found in different cases (Fig. 3). For those patients with lymph node metastases (regional recurrence), contrast-enhanced CT was false-positive in two cases, compared with no false-positive FDG-PET findings. CT was false-negative in two cases, compared with one case for FDG-PET (Fig. 4). The overall accuracy of post-CRT FDG-PET and CT in evaluating local recurrence was 83% and 83% respectively, and 94% versus 78% for regional recurrence.Fig. 3

Bottom Line: The prognostic performance of post-CRT PET and CT for recurrence was compared.Patients with positive post-CRT PET exhibited significantly lower 2-year cause-specific survival and disease-free survival (50% vs. 91%, P < 0.05 and 0% vs. 83%, P < 0.0001); however, patients with positive post-CRT CT did not exhibit any significant difference (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070).The prognostic accuracy of post-CRT PET is superior to that of CT.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Osaka University School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. keisuke.enomoto@tracer.med.osaka-u.ac.jp

ABSTRACT

Purpose: The purpose of this study was to evaluate the predictive value of 2-deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography (FDG-PET) following concurrent chemoradiotherapy (CRT) on survival in patients with carcinoma of the oropharynx (OPC).

Methods: Eighteen patients with primary OPC who underwent PET pre- and post-CRT were evaluated prospectively for survival. The prognostic performance of post-CRT PET and CT for recurrence was compared.

Results: Patients with positive post-CRT PET exhibited significantly lower 2-year cause-specific survival and disease-free survival (50% vs. 91%, P < 0.05 and 0% vs. 83%, P < 0.0001); however, patients with positive post-CRT CT did not exhibit any significant difference (67% vs. 83%, P = 0.416 and 50% vs. 75%, P = 0.070). Other factors, such as clinical and pre-CRT PET variables, also did not indicate any significant difference. The accuracy of prediction of residual and local recurrence for post-CRT PET and CT (local%/regional%) was 83%/94% and 83%/78%, respectively.

Conclusion: OPC patients with positive post-CRT PET exhibit poor survival. The prognostic accuracy of post-CRT PET is superior to that of CT. The results of post-CRT FDG-PET should be included in the management of the OPC patients.

Show MeSH
Related in: MedlinePlus