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

37 Citations (Scopus)

Abstract

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
Volume205
Issue number3
DOIs
StatePublished - Jan 1 2015

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Head and Neck Neoplasms
Meta-Analysis
Recurrence
Therapeutics
Sensitivity and Specificity
MEDLINE
Libraries

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

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

In: American Journal of Roentgenology, Vol. 205, No. 3, 01.01.2015, p. 629-639.

Research output: Contribution to journalReview article

Sheikhbahaei, Sara ; Taghipour, Mehdi ; Ahmad, Rubina ; Fakhry, Carole ; Kiess, Ana P. ; Chung, Christine H. ; Subramaniam, Rathan M. / 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. In: American Journal of Roentgenology. 2015 ; Vol. 205, No. 3. pp. 629-639.
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abstract = "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.",
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T1 - Diagnostic accuracy of follow-up FDG PET or PET/CT in patients with head and neck cancer after definitive treatment

T2 - A systematic review and meta-analysis

AU - Sheikhbahaei, Sara

AU - Taghipour, Mehdi

AU - Ahmad, Rubina

AU - Fakhry, Carole

AU - Kiess, Ana P.

AU - Chung, Christine H.

AU - Subramaniam, Rathan M.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - 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.

AB - 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.

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KW - Follow-up

KW - Head and neck neoplasm

KW - Meta-analysis

KW - PET/CT

KW - Recurrence

KW - Sensitivity and specificity

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