Diagnostic accuracy of follow-up FDG PET or PET/CT in patients with head and neck cancer after definitive treatment: A systematic review and meta-analysis

Sara Sheikhbahaei, Mehdi Taghipour, Rubina Ahmad, Carole Fakhry, Ana P. Kiess, Christine H. Chung, Rathan M. Subramaniam

Research output: Contribution to journalReview article

38 Scopus citations


OBJECTIVE. The purpose of this study was to assess the diagnostic performance of FDG PET or PET/CT for detection of local, regional, and distant recurrences in the follow-up of patients with head and neck cancer who underwent definitive treatment. MATERIALS AND METHODS. A systematic search was performed in MEDLINE and Cochrane Library (updated September 2014) to identify relevant published studies. Studies investigating the accuracy of FDG PET/CT that were performed at least 4 months after therapy were included. Two authors independently screened all retrieved articles, selected studies that met the inclusion criteria, and extracted the data. Histopathologic confirmation or clinical follow-up of at least 6 month (or both) was considered as the reference standard. RESULTS. Twenty-three studies constituting a total of 2247 FDG PET/CT examinations met our inclusion criteria. The pooled sensitivity and specificity of follow-up PET/CT for detection of recurrence were 0.92 (95% CI, 0.90-0.94), and 0.87 (95% CI, 0.82-0.91), respectively. The pooled sensitivity and specificity of scans performed 4-12 months after treatment were 0.95 (95% CI, 0.91-0.97) and 0.78 (95% CI, 0.70-0.84), respectively. Similar estimates for scans performed at or more than 12 months after treatment were 0.92 (95% CI, 0.85-0.96) and 0.91 (95% CI, 0.78-0.96), respectively. The overall accuracy of FDG PET/CT in detecting recurrence is higher in patients without suspicion of recurrence before the scan compared with the patients with suspected recurrence. CONCLUSION. The high diagnostic performance of FDG PET/CT in detecting recurrence in curatively treated patients with head and neck cancer supports its use in clinical practice for patient follow-up. Further studies are needed to evaluate the prognostic utility of PET/CT in the follow-up of head and neck cancer.

Original languageEnglish (US)
Pages (from-to)629-639
Number of pages11
JournalAmerican Journal of Roentgenology
Issue number3
Publication statusPublished - Jan 1 2015



  • Follow-up
  • Head and neck neoplasm
  • Meta-analysis
  • PET/CT
  • Recurrence
  • Sensitivity and specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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