Clinical oncology : a journal of the Royal College of Radiologists
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Clin Oncol (R Coll Radiol) · Dec 2003
The impact of FDG PET on the management of occult primary head and neck tumours.
The aim of this study was to investigate the impact of positron-emission tomography (PET) with 18F-labelled fluoro-2-deoxy-D-glucose (FDG) in the management of occult primary head and neck tumours. ⋯ FDG PET suggested a primary site in eight of the 17 patients (tongue base 5; nasopharynx 1; tonsil 1: supraglottis 1). Pathological confirmation was obtained in four patients and one patient died of progressive disease at the primary site. In nine patients, the primary site was not identified on FDG PET. In six of these patients, no primary site was found during follow-up (range 8-36 months: mean 20 months). One patient died before treatment commenced, and there were two histologically confirmed false-negative FDG PET results: one tonsil SCC and one lateral pharyngeal wall SCC. FDG PET affected treatment plans in nine of the 17 (53%) patients in whom a primary site was suggested (altered radiotherapy plan 6; radiotherapy with curative intent to palliative radiotherapy 1; radiotherapy to surgery and post-operative radiotherapy 1), and in one patient where no occult primary was localised (radiotherapy to surgery 1). FDG PET had a sensitivity, specificity, positive and negative predictive value of 62%, 66%, 62% and 62%, respectively.