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Comparing staging by positron emission tomography with contrast-enhanced computed tomography and by pathology in head and neck squamous cell carcinoma

Published online by Cambridge University Press:  22 October 2015

J R Qualliotine ,
W K Mydlarz ,
J YK Chan ,
X Zhou ,
H Wang  and
N Agrawal
J R Qualliotine
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Division of Biostatistics and Bioinformatics, Johns Hopkins School of Medicine, Baltimore, MD, USA
W K Mydlarz
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Division of Biostatistics and Bioinformatics, Johns Hopkins School of Medicine, Baltimore, MD, USA
J YK Chan
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Division of Biostatistics and Bioinformatics, Johns Hopkins School of Medicine, Baltimore, MD, USA
X Zhou
Affiliation:
Department of Oncology, Division of Biostatistics and Bioinformatics, Johns Hopkins School of Medicine, Baltimore, MD, USA
H Wang
Affiliation:
Department of Oncology, Division of Biostatistics and Bioinformatics, Johns Hopkins School of Medicine, Baltimore, MD, USA
N Agrawal*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Division of Biostatistics and Bioinformatics, Johns Hopkins School of Medicine, Baltimore, MD, USA
*
Address for correspondence: Dr N Agrawal, Department of Otolaryngology – Head and Neck Surgery, 601 N. Caroline Street, JHOC 6th Floor, Baltimore, Maryland 21287, USA Fax: +1 410 955 6526 E-mail: nagrawal@jhmi.edu
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Abstract

Objective:

This study aimed to evaluate the ability of positron emission tomography with contrast-enhanced computed tomography to correctly stage head and neck squamous cell carcinomas, in comparison with pathological staging.

Methods:

Positron emission tomography computed tomography was used to determine the tumour–node–metastasis classification and overall cancer stage in 85 head and neck squamous cell carcinoma patients who underwent pre-operative imaging using this modality and primary surgery between July 2010 and January 2013. Staging by positron emission tomography computed tomography was retrospectively compared with staging using pathological specimens. Agreement between imaging stage and pathological stage was examined by univariate and multivariate analysis both overall and for each primary tumour site.

Results:

This imaging modality was 87.5 per cent sensitive and 44.8 per cent specific in identifying regional cervical metastases, and had false positive and false negative rates of 18.8 per cent and 8.2 per cent, respectively. The positive predictive and negative predictive values were 75.4 per cent and 65.0 per cent, respectively. Univariate and multivariate analyses revealed a significant agreement between positron emission tomography computed tomography and pathological node classification in older patients and for the oral cavity primary tumour site. There was significant agreement between both methods in the overall classification only for tumours classified as T3 or greater.

Conclusion:

Positron emission tomography computed tomography should be used with caution for the pre-operative staging of head and neck cancers because of its high false positive and false negative rates.

Keywords

Positron-Emission TomographyTomography, X-Ray ComputedNeoplasm StagingHead and Neck Neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 12 , December 2015 , pp. 1213 - 1219
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented as an oral presentation at the 5th World Congress of the International Federation of Head and Neck Oncologic Societies, 27–30 July 2014, New York City, New York, USA

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