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Patrick K. Ha, MD; Alia Hdeib, BS; David Goldenberg, MD; Heather Jacene, MD; Pavni Patel, MD; Wayne Koch, MD; Joseph Califano, MD; Charles W. Cummings, MD; Paul W. Flint, MD; Richard Wahl, MD; Ralph P. Tufano, MD

Arch Otolaryngol Head Neck Surg. 2006;132:12-16.

Objective  To evaluate the role of positron emission tomography and computed tomography (PET-CT) fusion in the management of early-stage and advanced-stage primary head and neck squamous cell cancer.

Design  Retrospective analysis, with a blinded evaluation of clinical data and formation of a treatment plan.

Setting  Single tertiary academic medical institution.

Patients  Thirty-six patients with previously untreated head and neck squamous cell carcinoma who underwent staging CT or magnetic resonance imaging of the neck prior to undergoing PET-CT as part of their initial diagnostic evaluation between July 2000 and January 2005.

Main Outcome Measures  Confirmation or alteration of the treatment plan with the addition of the PET-CT information compared with traditional clinical and radiological data alone for early-stage and advanced-stage disease. When available, histopathological results were correlated with the PET-CT findings.

Results  Among the 36 patients, PET-CT provided additional information that confirmed the treatment plan in 25 patients (69%) and altered the treatment plan in 11 patients (31%). Six of 11 patients in the altered-treatment group had their tumors upstaged. Four of 8 patients with early-stage tumors had their treatment plan altered, compared with 7 of 28 patients with advanced-stage disease. Among 18 patients who underwent a surgical intervention for their primary tumor, PET-CT identified the primary tumor in all 18 patients and, based on histopathological findings, correctly staged the regional nodal disease in 9 of 16 patients who had their nodal disease addressed.

Conclusion  The use of PET-CT is important in the initial treatment planning of early-stage and advanced-stage head and neck squamous cell carcinoma.

Author Affiliations: Departments of Otolaryngology–Head and Neck Surgery (Drs Ha, Goldenberg, Koch, Califano, Cummings, Flint, and Tufano) and Nuclear Medicine (Drs Jacene, Patel, and Wahl), The Johns Hopkins University School of Medicine (Ms Hdeib), Baltimore, Md.