The value of follow‐up FDG‐PET/CT in the management and prognosis of patients with HPV‐positive oropharyngeal squamous cell carcinoma. Issue 6 (7th September 2015)

• Record Type: Journal Article
• Authors: Taghipour, Mehdi; Marcus, Charles; Califano, Joseph; Fakhry, Carole; Subramaniam, Rathan M
• Is Part Of: Journal of medical imaging and radiation oncology. Volume 59:Issue 6(2015)
• Page Start: 681
• Page End: 686
• Publication Date: 2015-09-07
• Subjects: accuracy -- follow‐up -- HPV -- oropharyngeal SCC -- PET/CT -- survival; Radiology, Medical -- Periodicals; Radiology, Medical -- Australasia -- Periodicals; 616.0757
• DOI: 10.1111/1754-9485.12354
• Languages: English
• ISSNs: 1754-9477

Abstract

Abstract: Introduction: To establish the accuracy of follow‐up fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT and the impact of FDG PET/CT result on management decisions and patient outcome prediction (overall and progression free survival) in human papilloma virus (HPV)‐positive oropharyngeal squamous cell carcinoma (SCC). Patients and Methods: We included 96 HPV‐positive oropharyngeal SCC (OPSCC) patients with 254 follow‐up PET/CT scans in the study. The PET/CT result accuracy was established with histopathology or 6‐month clinical follow‐up as reference standard. The impact on change in management was established for each follow‐up PET/CT scan. Overall survival was evaluated using Kaplan–Meier plots with a Log‐rank test. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the follow‐up FDG‐PET/CT were 97.0%, 92.5%, 67.0%, 99.5% and 93.1%, respectively. Follow‐up PET/CT results were helpful in excluding tumour in 22% (9/41) of scans performed with prior clinical suspicion of disease and identified potential disease in 9.9% (21/213) scans performed without prior clinical suspicion. There was a change in management after 12.6% (32/254) scans. In 84.3% (214/254) scans, the patients were either observed or the same treatment was continued. The overall survival differed significantly between patients with a negative versus positive follow‐up scan (log rank P < 0.001). The median progression free survival was 28 months, if the first follow‐up scan performed within 6–12 months post‐treatment completion was negative. Conclusion: Follow‐up FDG PET/CT scans have an impact on the management plan and add value to clinical assessment in patients with HPV‐positive OPSCC.