The aim of the present study was to assess the value of dual-head gamma-camera (DHGC) imaging in the coincidence mode using 2-[18F]-fluoro-2-deoxy-D-glucose in differentiating recurrent tumor from posttreatment changes in previously treated head and neck cancer.
This was a single-center prospective study performed with the approval of our Institutional Review Board. Twenty-nine patients with suspected recurrent head and neck cancers were prospectively enrolled in this study. Dual-head gamma-camera imaging in the coincidence mode followed computed tomography (CT; n = 24)/magnetic resonance imaging (MRI; n = 5) within a period of 1 week (mean = 3.5 days) in all patients. Thirteen patients had definite pathologic confirmation of recurrence by undergoing a biopsy. Sixteen patients, however, did not have a definite pathologic confirmation and were followed clinically. The mean duration of follow-up for the subgroup of patients who were followed clinically was 22.8 months (range: 4-48 months). Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for CT/MRI and DHGC imaging in the coincidence mode were calculated.
The sensitivity, specificity, PPV, NPV, and accuracy of CT/MRI in the detection of recurrent cancer were 76.5%, 58.3%, 72.2%, 63.6%, and 69%, respectively. In contrast, the sensitivity (100%), NPV (100%), and accuracy (82.8%) of DHGC imaging in the coincidence mode were superior to that of CT/MRI. Dual-head gamma-camera imaging in the coincidence mode had a specificity (58.3%) and PPV (77.3%) comparable to those of CT/MRI.
Our data suggest that modified positron emission tomography with DHGC imaging in the coincidence mode is a useful tool in the assessment of recurrent head and neck cancer.
From the *Division of Neuroradiology, Department of Radiology, University of Michigan Health System, Ann Arbor, MI; †Department of Radiology, University of North Carolina Hospitals, Chapel Hill, NC; and ‡Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of North Carolina Hospitals, Chapel Hill, NC.
Received for publication July 27, 2004; accepted March 25, 2005.
Supported in part by Siemens, Erlangen, Germany.
Reprints: Dheeraj Gandhi, Division of Neuroradiology, Department of Radiology, University of Michigan Health System, UH-B1-D435, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0030 (e-mail: firstname.lastname@example.org).