ORIGINAL ARTICLE CLINICAL IMPACT OF, AND PROGNOSTIC STRATIFICATION BY, F-18 FDG PET/CT IN HEAD AND NECK MUCOSAL SQUAMOUS CELL

Abstract: Background. The aim of this study was to deter-mine prospectively the incremental value of positron emission to-mography/computed tomography (PET/CT) over conventional assessment (clinical examination and CT/MRI imaging). Methods. All patients undergoing 18F-fluorodeoxyglucose (FDG)-PET/CT for primary head and neck mucosal squamous cell carcinoma between January 2002 and December 2003 (in-clusive) were included in this study provided they had under-gone contemporaneous conventional assessment of the head and neck region and had 12 months minimum follow-up. Results. Seventy-six patients underwent 100 PET/CT scans. The majority of patients (74%) were treated with definitive (chemo)-radiotherapy. Median follow-up time was 28 months. PET/CT led to a TNM classification alteration in 34 % (12/35), a change in radio-therapy planning technique and/or dose in 29 % (10/35), and altered treatment response assessment in 43 % (13/30). A complete metabolic response was predictive of overall survival (p .037). Conclusion. Our results support incorporation of PET/CT into the management paradigm of head and neck mucosal squa