Bone and liver scans in patients with head and neck carcinoma

The initial evaluation of patients with malignant tumors of the head and neck must include an attempt to determine the presence or absence of distant metastases so that the patient's tumor can be accurately staged and appropriate treatment planned. To determine the value of routine bone and liver scans in detecting distant metastases, the records of 169 patients with head and neck carcinoma, on whom such scans were performed, were reviewed retrospectively. No true positive liver scans were found and the incidence of true positive bone scans was only 2%. It is felt, therefore, that routine scanning is not a worthwhile procedure and we recommend that liver and bone scans be reserved for those patients with advanced primary tumors, with regional node metastases or with clinical or laboratory evidence of liver or bone involvement.