Use of positron emission tomography/computed tomography in the initial staging of head and neck squamous cell carcinoma: Accuracy in the evaluation of the primary site of the tumor, metastases to cervical lymph nodes, and distant metastases

• Authors: Zuzana Krátká , Jan Paska , Ales Kavka , Monika Jaruskova , Radka Lohynska , Katerina Lickova , Ales Cocek

Abstracts

EN

Aim: Our study aimed to evaluate the use of positron emission tomography/computed tomography (PET/CT) in the initial staging of head and neck squamous cell carcinoma (HNSCC), including assessment of local and distant spread of the disease. We also aimed to compare the accuracy of PET/CT in the evaluation of human papillomavirus (HPV) positive and HPV-negative oropharyngeal carcinoma. Material and methods: This single-center, prospective study was conducted between August 2016 and September 2021. A total of 198 patients with HNSCC who underwent PET/CT within the primary staging were included. We compared PET/ CT results with histological findings. We calculated the accuracy, sensitivity, specificity, and positive and negative predictive values to assess the primary tumor, cervical lymph nodes, and distant metastases. Results: PET/CT showed a high success rate (32%) in revealing the primary site of carcinoma of unknown primary (CUP). The accuracy of PET/CT in displaying the primary tumor, cervical lymph node metastases, and distant metastases was 89.4%, 85.4%, and 87.4%, respectively. The method provided high sensitivity but lower specificity in all three areas. Specifically, PET/CT showed low specificity in the assessment of small tumors (75%), metastatic involvement of cervical lymph nodes (69.6%), and HPV-posi- tive oropharyngeal carcinoma (55.6%). Conclusions: The high accuracy of PET/CT to identify distant metastases and whole-body staging in one diagnostic step acce- lerated primary staging and resulted in earlier commencement of therapy. However, it also led to an overestimation of clinical findings and thus to extensive surgical treatment, especially in patients with small tumors, metastatic involvement of cervical lymph nodes, and HPV-positive oropharyngeal carcinoma. PET/CT is also useful for CUP diagnostics.

Keywords

EN

carcinoma of unknown primary; head and neck squamous cell carcinoma; human papillomavirus; PET/CT

• Publisher: Index Copernicus International
• Journal: Polish Journal of Otolaryngology
• Year: 2022
• Volume: 76
• Issue: 6
• Pages: 14-21

Dates

published

2022

Contributors

author

Zuzana Krátká

• Thomayer University Hospital, Department of Otorhinolaryngology, Prague, Czech Republic

author

Jan Paska

• Thomayer University Hospital, Department of Otorhinolaryngology, Prague, Czech Republic

author

Ales Kavka

• Na Homolce Hospital, Department of Nuclear Medicine – PET Center, Prague, Czech Republic

author

Monika Jaruskova

• Na Homolce Hospital, Department of Nuclear Medicine – PET Center, Prague, Czech Republic

author

Radka Lohynska

• Thomayer University Hospital, Department of Oncology of the First Faculty of Medicine, Charles University and Thomayer University Hospital, Prague, Czech Republic

author

Katerina Lickova

• University Hospital Kralovske Vinohrady, Department of Radiotherapy and Oncology of the Third Faculty, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic

author

Ales Cocek

• Thomayer University Hospital, Department of Otorhinolaryngology, Prague, Czech Republic

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Identifiers

DOI

10.5604/01.3001.0015.9817

Biblioteka Nauki

58457447