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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

24.02.2018 | Review Article

FDG-PET/CT for treatment response assessment in head and neck squamous cell carcinoma: a systematic review and meta-analysis of diagnostic performance

verfasst von: Nils Helsen, Tim Van den Wyngaert, Laurens Carp, Sigrid Stroobants

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 6/2018

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Abstract

Purpose

18-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is increasingly used to evaluate treatment response in head and neck squamous cell carcinoma (HNSCC). This analysis assessed the diagnostic value of FDG-PET/CT in detecting nodal disease within 6 months after treatment, considering patient and disease characteristics.

Methods

A systematic review was performed using the MEDLINE and Web of Knowledge databases. The results were pooled using a bivariate random effects model of the sensitivity and specificity.

Results

Out of 22 identified studies, a meta-analysis of 20 studies (1293 patients) was performed. The pooled estimates of sensitivity, specificity and diagnostic odds ratio (with 95% CI) were 85% (76–91%), 93% (89–96%) and 76 (35–165), respectively. With the prevalence set at 10%, the positive and negative predictive values were 58% and 98%. There was significant heterogeneity between the trials (p < 0.001). HPV positive tumors were associated with lower sensitivity (75% vs 89%; p = 0.01) and specificity (87% vs 95%; p < 0.005).

Conclusion

FDG-PET/CT within 6 months after (chemo)radiotherapy in HNSCC patients is a reliable method for ruling out residual/recurrent nodal disease and obviates the need for therapeutic intervention. However, FDG-PET/CT may be less reliable in HPV positive tumors and the optimal surveillance strategy remains to be determined.

Nur mit Berechtigung zugänglich

Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108.CrossRefPubMed

Marur S, Forastiere AA. Head and neck cancer: changing epidemiology, diagnosis, and treatment. Mayo Clin Proc. 2008;83:489–501.CrossRefPubMed

Petrelli F, Coinu A, Riboldi V, Borgonovo K, Ghilardi M, Cabiddu M, et al. Concomitant platinum-based chemotherapy or cetuximab with radiotherapy for locally advanced head and neck cancer: a systematic review and meta-analysis of published studies. Oral Oncol. 2014;50:1041–8.CrossRefPubMed

Barkley HT, Fletcher GH, Jesse RH, Lindberg RD. Management of cervical lymph node metastases in squamous cell carcinoma of the tonsillar fossa, base of tongue, supraglottic larynx, and hypopharynx. Am J Surg. 1972;124:462–7.CrossRefPubMed

Hamoir M, Ferlito A, Schmitz S, Hanin FX, Thariat J, Weynand B, et al. The role of neck dissection in the setting of chemoradiation therapy for head and neck squamous cell carcinoma with advanced neck disease. Oral Oncol. 2012;48:203–10.CrossRefPubMed

Posner M, Hershock D, Blajman C, Mickiewicz E, Winquist E, Gorbounova V, et al. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N Engl J Med. 2007;357:1705–15.CrossRefPubMed

Lavertu P, Adelstein D, Saxton J, Secic M, Wanamaker J, Eliachar I, et al. Management of the neck in a randomized trial comparing concurrent chemotherapy and radiotherapy with radiotherapy alone in resectable stage III and IV squamous cell head and neck cancer. Head Neck. 1997;19:559–66.CrossRefPubMed

McHam SA, Adelstein DJ, Rybicki LA, Lavertu P, Esclamado RM, Wood BG, et al. Who merits a neck dissection after definitive chemoradiotherapy for N2-N3 squamous cell head and neck cancer? Head Neck. 2003;25:791–8.CrossRefPubMed

Isles MG, McConkey C, Mehanna HM. A systematic review and meta-analysis of the role of positron emission tomography in the follow up of head and neck squamous cell carcinoma following radiotherapy or chemoradiotherapy. Clin Otolaryngol. 2008;33:210–22.CrossRefPubMed

10.

Gupta T, Master Z, Kannan S, Agarwal JP, Ghsoh-Laskar S, Rangarajan V, et al. Diagnostic performance of post-treatment FDG PET or FDG PET/CT imaging in head and neck cancer: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging. 2011;38:2083–95.CrossRefPubMed

11.

Gourin CG, Boyce BJ, Williams HT, Herdman AV, Bilodeau PA, Coleman TA. Revisiting the role of positron-emission tomography/computed tomography in determining the need for planned neck dissection following chemoradiation for advanced head and neck cancer. Laryngoscope. 2009;119:2150–5.CrossRefPubMed

12.

Moeller BJ, Rana V, Cannon BA, Williams MD, Sturgis EM, Ginsberg LE, et al. Prospective risk-adjusted [18F]fluorodeoxyglucose positron emission tomography and computed tomography assessment of radiation response in head and neck cancer. J Clin Oncol. 2009;27:2509–15.CrossRefPubMedPubMedCentral

13.

Fakhry N, Barberet M, Paris J, Jacob T, Deveze A, Mundler O, et al. Intérêt de la TEP au 18FDG couplée à la TDM dans la surveillance post-thérapeutiquedes carcinomes épidermoïdesdes voies aérodigestives supérieures. Ann Otolaryngol Chir Cervicofac. 2006;123:167–74.CrossRefPubMed

14.

Ito K, Yokoyama J, Kubota K, Morooka M, Shiibashi M, Matsuda H. 18F-FDG versus 11C-choline PET/CT for the imaging of advanced head and neck cancer after combined intra-arterial chemotherapy and radiotherapy: the time period during which PET/CT can reliably detect non-recurrence. Eur J Nucl Med Mol Imaging. 2010;37:1318–27.CrossRefPubMed

15.

Nayak JV, Walvekar RR, Andrade RS, Daamen N, Lai SY, Argiris A, et al. Deferring planned neck dissection following chemoradiation for stage IV head and neck cancer: the utility of PET-CT. Laryngoscope. 2007;117:2129–34.CrossRefPubMed

16.

Cho AH, Shah S, Ampil F, Bhartur S, Nathan C-AO. N2 disease in patients with head and neck squamous cell cancer treated with chemoradiotherapy: is there a role for posttreatment neck dissection? Arch Otolaryngol Head Neck Surg. 2009;135:1112–8.CrossRefPubMed

17.

Chan JYK, Sanguineti G, Richmon JD, Marur S, Gourin CG, Koch W, et al. Retrospective review of positron emission tomography with contrast-enhanced computed tomography in the posttreatment setting in human papillomavirus-associated oropharyngeal carcinoma. Arch Otolaryngol Head Neck Surg. 2012;138:1040–6.CrossRefPubMedPubMedCentral

18.

Ng SH, Chan SC, Yen TC, Liao CT, Lin CY, Tung-Chieh Chang J, et al. PET/CT and 3-T whole-body MRI in the detection of malignancy in treated oropharyngeal and hypopharyngeal carcinoma. Eur J Nucl Med Mol Imaging. 2011;38:996–1008.CrossRefPubMed

19.

Chen AY, Vilaseca I, Hudgins PA, Schuster D, Halkar R. PET-CT vs contrast-enhanced CT: what is the role for each after chemoradiation for advanced oropharyngeal cancer? Head Neck. 2006;28:487–95.CrossRefPubMed

20.

Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol. 2014;14.

21.

Stein AP, Saha S, Kraninger JL, Swick AD, Yu M, Lambert PF, et al. Prevalence of human papillomavirus in oropharyngeal cancer: a systematic review. Cancer J. 2015;21:138–46.CrossRefPubMedPubMedCentral

22.

Whiting P, Rutjes A, Westwood M, Mallett S, Deeks J, Reitsma J, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155:529–36.CrossRefPubMed

23.

Jüni P, Witschi A, Bloch R, Egger M. The hazards of scoring the quality of clinical trials for meta-analysis. JAMA. 1999;282:1054–60.CrossRefPubMed

24.

Møller B, Weedon-Fekjaer H, Haldorsen T. Empirical evaluation of prediction intervals for cancer incidence. BMC Med Res Methodol. 2005;5:21.CrossRefPubMedPubMedCentral

25.

Harbord RM, Deeks JJ, Egger M, Whiting P, Sterne JA. A unification of models for meta-analysis of diagnostic accuracy studies. Biostatistics. 2007;8:239–51.CrossRefPubMed

26.

Reitsma JB, Glas AS, Rutjes AW, Scholten RJ, Bossuyt PM, Zwinderman AH. Bivariate analysis of sensitivity and specificity produces informative summary measures in diagnostic reviews. J Clin Epidemiol. 2005;58:982–90.CrossRefPubMed

27.

Helsen N, Roothans D, Van Den Heuvel B, Van den Wyngaert T, van den Weyngaert D, Carp L, et al. 18F-FDG-PET/CT for the detection of disease in patients with head and neck cancer treated with radiotherapy. PLoS One. 2017;12:e0182350.CrossRefPubMedPubMedCentral

28.

Bird T, Barrington S, Thavaraj S, Jeannon JP, Lyons A, Oakley R, et al. 18F-FDG PET/CT to assess response and guide risk-stratified follow-up after chemoradiotherapy for oropharyngeal squamous cell carcinoma. Eur J Nucl Med Mol Imaging. 2016;43:1239–47.CrossRefPubMed

29.

Connell CA, Corry J, Milner AD, Hogg A, Hicks RJ, Rischin D, et al. Clinical impact of, and prognostic stratification by, F-18 FDG PET/CT in head and neck mucosal squamous cell carcinoma. Head Neck. 2007;29:986–95.CrossRefPubMed

30.

Gupta T, Jain S, Agarwal JP, Rangarajan V, Purandare N, Ghosh-Laskar S, et al. Diagnostic performance of response assessment FDG-PET/CT in patients with head and neck squamous cell carcinoma treated with high-precision definitive (chemo)radiation. Radiother Oncol. 2010;97:194–9.CrossRefPubMed

31.

Keski-Säntti H, Mustonen T, Schildt J, Saarilahti K, Mäkitie A. FDG-PET/CT in the assessment of treatment response after oncologic treatment of head and neck squamous cell carcinoma. Clin. Med. Insights ear. Nose Throat. 2014;19:25–9.

32.

Loo SW, Geropantas K, Beadsmoore C, Montgomery PQ, Martin WM, Roques TW. Neck dissection can be avoided after sequential chemoradiotherapy and negative post-treatment positron emission tomography-computed tomography in N2 head and neck squamous cell carcinoma. Clin Oncol. 2011;23:512–7.CrossRef

33.

Malone JP, Gerberi MA, Vasireddy S, Hughes LF, Rao K, Shevlin B, et al. Early prediction of response to chemoradiotherapy for head and neck cancer: reliability of restaging with combined positron emission tomography and computed tomography. Arch Otolaryngol Head Neck Surg. 2009;135:1119–25.CrossRefPubMed

34.

Porceddu SV, Pryor DI, Burmeister E, Burmeister BH, Poulsen MG, Foote MC, et al. Results of a prospective study of positron emission tomography-directed management of residual nodal abnormalities in node-positive head and neck cancer after definitive radiotherapy with or without systemic therapy. Head Neck. 2011;33:1675–82.CrossRefPubMed

35.

Prestwich RJ, Subesinghe M, Gilbert A, Chowdhury FU, Sen M, Scarsbrook AF. Delayed response assessment with FDG-PET-CT following (chemo)radiotherapy for locally advanced head and neck squamous cell carcinoma. Clin Radiol. 2012;67:966–75.CrossRefPubMed

36.

Rabalais AG, Walvekar R, Nuss D, McWhorter A, Wood C, Fields R, et al. Positron emission tomography-computed tomography surveillance for the node-positive neck after chemoradiotherapy. Laryngoscope. 2009;119:1120–4.CrossRefPubMed

37.

Schouten CS, de Graaf P, Alberts FM, Hoekstra OS, Comans EF, Bloemena E, et al. Response evaluation after chemoradiotherapy for advanced nodal disease in head and neck cancer using diffusion-weighted MRI and 18F-FDG-PET-CT. Oral Oncol. 2015;51:541–7.CrossRefPubMed

38.

Sjövall J, Bitzén U, Kjellén E, Nilsson P, Wahlberg P, Brun E. Qualitative interpretation of PET scans using a Likert scale to assess neck node response to radiotherapy in head and neck cancer. Eur J Nucl Med Mol Imaging. 2016;43:609–16.CrossRefPubMed

39.

Slevin F, Subesinghe M, Ramasamy S, Sen M, Scarsbrook AF, Prestwich RJD. Assessment of outcomes with delayed 18F-FDG PET-CT response assessment in head and neck squamous cell carcinoma. Br J Radiol. 2015;88:20140592.CrossRefPubMedPubMedCentral

40.

Vainshtein JM, Spector ME, Stenmark MH, Bradford CR, Wolf GT, Worden FP, et al. Reliability of post-chemoradiotherapy F-18-FDG PET/CT for prediction of locoregional failure in human papillomavirus-associated oropharyngeal cancer. Oral Oncol. 2014;50:234–9.CrossRefPubMed

41.

Zundel MT, Michel MA, Schultz CJ, Maheshwari M, Wong SJ, Campbell BH, et al. Comparison of physical examination and fluorodeoxyglucose positron emission tomography/computed tomography 4-6 months after radiotherapy to assess residual head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2011;81:825–32.CrossRef

42.

Mehanna H, Wong W-L, McConkey CC, Rahman JK, Robinson M, Hartley AG, et al. PET-CT surveillance versus neck dissection in advanced head and neck cancer. N Engl J Med. 2016;374:1444–54.CrossRefPubMed

43.

Fakhry N, Lussato D, Jacob T, Giorgi R, Giovanni A, Zanaret M. Comparison between PET and PET/CT in recurrent head and neck cancer and clinical implications. Eur Arch Otorhinolaryngol. 2007;264:531–8.CrossRefPubMed

44.

Goshen E, Davidson T, Yahalom R, Talmi YP, Zwas ST. PET/CT in the evaluation of patients with squamous cell cancer of the head and neck. Int J Oral Maxillofac Surg. 2006;35:332–6.CrossRefPubMed

45.

Krupar R, Robold K, Gaag D, Spanier G, Kreutz M, Renner K, et al. Immunologic and metabolic characteristics of HPV-negative and HPV-positive head and neck squamous cell carcinomas are strikingly different. Virchows Arch. 2014;465:299–312.CrossRefPubMed

46.

Tahari AK, Alluri KC, Quon H, Koch W, Wahl RL, Subramaniam RM. FDG PET/CT imaging of oropharyngeal squamous cell carcinoma: characteristics of human papillomavirus-positive and -negative tumors. Clin Nucl Med. 2014;39:225–31.CrossRefPubMedPubMedCentral

47.

Clark J, Jeffery CC, Zhang H, Cooper T, O’Connell DA, Harris J, et al. Correlation of PET-CT nodal SUVmax with p16 positivity in oropharyngeal squamous cell carcinoma. J Otolaryngol Head Neck Surg. 2015;44.

48.

Ang K, Harris J, Wheeler R, Weber R, Rosenthal D, Nguyen-Tân P, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med. 2010;363:24–35.CrossRefPubMedPubMedCentral

49.

Mirghani H, Amen F, Tao Y, Deutsch E, Levy A. Increased radiosensitivity of HPV-positive head and neck cancers: molecular basis and therapeutic perspectives. Cancer Treat Rev. 2015;41:844–52.CrossRefPubMed

50.

Huang SH, O’Sullivan BO, Xu W, Zhao H, Chen D, Ringash J, et al. Temporal nodal regression and regional control after primary radiation therapy for N2-N3 head-and-neck cancer stratified by HPV status. Radiat Oncol Biol Elsevier Inc. 2013;87:1078–85.CrossRef

51.

Marcus C, Ciarallo A, Tahari AK, Mena E, Koch W, Wahl RL, et al. Head and neck PET/CT: therapy response interpretation criteria (Hopkins criteria)-interreader reliability, accuracy, and survival outcomes. J Nucl Med. 2014;55:1411–6.CrossRefPubMedPubMedCentral

52.

Aide N, Lasnon C, Veit-Haibach P, Sera T, Sattler B, Boellaard R. EANM/EARL harmonization strategies in PET quantification: from daily practice to multicentre oncological studies. Eur J Nucl Med Mol Imaging. 2017;44:17–31.CrossRefPubMedPubMedCentral

Titel: FDG-PET/CT for treatment response assessment in head and neck squamous cell carcinoma: a systematic review and meta-analysis of diagnostic performance
verfasst von: Nils Helsen
Tim Van den Wyngaert
Laurens Carp
Sigrid Stroobants
Publikationsdatum: 24.02.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 6/2018
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-018-3978-3

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FDG-PET/CT for treatment response assessment in head and neck squamous cell carcinoma: a systematic review and meta-analysis of diagnostic performance

Abstract

Purpose

Methods

Results

Conclusion

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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