Diagnostic and prognostic value of [18F]fluorodeoxyglucose positron emission tomography for recurrent head and neck squamous cell carcinoma
Diagnostic and prognostic value of [18F]fluorodeoxyglucose positron emission tomography for recurrent head and neck squamous cell carcinoma
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DOI：
10.1200/jco.2002.02.590
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发表时间：
2002-10-15
影响因子：
45.3
通讯作者：
Kraus, DH
中科院分区：
文献类型：
--
作者：
Wong, RJ;Lin, DT;Kraus, DH
目的：复发性头颈部鳞状细胞癌（HNSCC）的患者提出了诊断和治疗的挑战。我们评估了[F-18]氟脱氧葡萄糖正电子发射断层扫描（PET）在此患者population.Patients和方法的诊断准确性和预后价值：我们进行了回顾性分析，143例既往治疗HNSCC谁接受了181 PET扫描在我们的机构从1996年5月至2001年4月，以检测复发性疾病。6个月内的疾病复发被用作金标准，用于评估真正的疾病状态在PET.Results：可疑网站被认为是积极的，PET检测复发的敏感性和特异性分别为96%和72%。PET在区域和远处部位具有高度敏感性和特异性。在当地站点，敏感性高，但特异性较低，因为假阳性结果。五分之一的假阳性PET扫描发生在已知的炎症或感染部位。基于标准化摄取值（SUV）的受试者工作特征曲线的曲线下面积为0.882 +/- 0.025。在时间依赖性多变量比例风险模型中，PET解释、SUV和体格检查是无复发和总生存率的独立预测因素。SUV每增加一个单位，复发的相对风险（RR）增加11%，死亡的RR增加14%。一个积极的PET解释增加了四倍的复发和死亡的RR由sevenfold.Conclusion：PET是一个高度敏感的方法检测复发HNSCC，并提供了重要的预后信息，无复发和总生存。
Purpose : Patients with recurrent head and neck squamous cell carcinoma (HNSCC) present a diagnostic and therapeutic challenge. We evaluated the diagnostic accuracy and prognostic value of [F-18]fluorodeoxyglucose positron emission tomography (PET) in this patient population.Patients and Methods: We performed a retrospective review of 143 patients with previously treated HNSCC who underwent 181 PET scans at our institution from May 1996 through April 2001 to detect recurrent disease. Disease recurrence within 6 months was used as the gold standard for assessing true disease status at PET.Results: With equivocal sites considered positive, the sensitivity and specificity of PET for detecting recurrence overall were 96% and 72%, respectively. PET was highly sensitive and specific at regional and distant sites. At local sites, sensitivity was high, but specificity was lower because of false-positive findings. One fifth of all false-positive PET scans occurred at sites of known inflammation or infection. The area under the curve for a receiver operator characteristic curve on the basis of standardized uptake value (SUV) was 0.882 +/- 0.025. PET interpretation, SUV, and physical examination were independent predictors of relapse-free and overall survival in a time-dependent, multivariate proportional hazards model. An increase in SUV by one unit increased the relative risk (RR) of relapse by 11% and the RR of death by 14%. A positive PET interpretation increased the RR of relapse by four-fold and the RR of death by seven-fold.Conclusion: PET was a highly sensitive method of detecting recurrent HNSCC and provided important prognostic information for relapse-free and overall survival.