18F-FDG PET/CT for detecting distant metastases in patients with recurrent head and neck squamous cell carcinoma

Distant metastases (DMs) increase in patients with recurrent head and neck squamous cell carcinoma (HNSCC). We evaluated the ability of fluorine 18-fluorodeoxyglucose ((18) F-FDG) positron emission tomography/computed tomography (PET/CT) to detect DMs in these patients.

We evaluated 82 consecutive patients with histologically confirmed recurrent HNSCC. Patients with previous DMs were excluded. All patients received whole-body (18) F-FDG PET/CT scanning for restaging of recurrent HNSCC and follow-up after salvage surgery. Any suspected DMs were confirmed by histology and further imaging workups. The diagnostic ability of (18) F-FDG PET/CT to detect DMs was assessed.

Of the 82 patients, 14 (17%) had DMs. The lung (93%) and bone (43%) were the most frequent metastatic sites. (18) F-FDG PET/CT correctly diagnosed the presence of DMs in 12 of 14 patients and their absence in 57 of 68 patients. The sensitivity, specificity, accuracy, and positive (PPV) and negative predictive values (NPV) of (18) F-FDG PET/CT for detecting DMs were 86% (95% confidence interval, 57-98%), 84% (72-91%), 84% (74-91%), 52% (30-73%), and 97% (88-99%), respectively.

(18) F-FDG PET/CT may be useful in the detection of DMs prior to and after salvage surgery in the high-risk patients with recurrent HNSCC.