Early PET-CT predicts treatment response of head and neck cancer

Source: www.curetoday.com Author: staff In patients with advanced squamous cell carcinoma of the head and neck, negative findings on post-treatment positron emission tomography/computed tomography (PET-CT) predict a good treatment response, researchers say. In 31 patients with clinical stage III and IV tumors treated with cisplatin and concurrent external beam radiotherapy, PET-CT was performed 6 to 8 weeks after therapy was completed, along with a comprehensive physical examination of the head and neck, as reported by Dr. James P. Malone, from the Southern Illinois School of Medicine, Springfield, and colleagues in the November Archives of Otolaryngology -- Head and Neck Surgery. Seventeen patients had evidence of persistent disease on physical exam, CT, and/or PET-CT, and these individuals had surgery for further evaluation. Fourteen patients had complete clinical responses, including no evidence of FDG uptake on PET-CT; these subjects were observed with routine follow-up. According to the researchers, all but one of these 14 patients remained disease free at the primary tumor site during a median follow-up of 26 months. Thus, the authors point out, the sensitivity of PET-CT was 83%, and its negative predictive value was "excellent" at 92% for detection of persistent disease at the primary tumor site. Because of a high false-positive rate, specificity was low at 54%, with a positive predictive value of 31%. Dr. Malone's group attributes the high false-positive rate to inflammation related to recent treatment. The investigators also note that 5 of 16 patients with abnormal FDG update developed local disease. "For patients with abnormal [...]

2009-11-18T16:19:03-07:00November, 2009|Oral Cancer News|

Impact of PET scanning consistent across all cancer types

Source: www.medscape.com Authors: Zosia Chustecka, Désirée Lie, MD Scanning with positron emission tomography (PET) scanning has an impact on the intended management of patients with cancer in approximately one third of cases, and new data suggest that this impact is consistent across all cancer types. The results come from the National Oncologic PET Registry (NOPR), and the latest data are reported in the December issue of the Journal of Nuclear Medicine. "Although the effectiveness of PET may differ somewhat between individual cancers, it's in the same ballpark," says coauthor Barry Siegel, MD, professor of radiology at Mallinckrodt Institute of Radiology in St. Louis, Missouri. "This result was a little unexpected, but it leads us to believe that a continual parsing of PET's usefulness, cancer by cancer and indication by indication, for purposes of reimbursement does not make clinical sense." At present in the United States, the Centers for Medicare & Medicaid Services (CMS) restricts the reimbursement of PET scans for only 9 cancer types. The cancers that are covered include non–small-cell lung cancer, esophageal cancer, colorectal cancer, head and neck cancer, lymphoma and melanoma (all for diagnosis, staging, and restaging), breast cancer (for restaging and treatment monitoring), thyroid cancer (for restaging under very specific circumstances), and cervical cancer (for initial staging if conventional imaging result is negative for extrapelvic metastasis). NOPR was launched in 2006 in response to a proposal from the CMS to expand coverage for PET to other cancers. In this registry, patients are covered under the CMS [...]

2008-12-04T12:49:17-07:00December, 2008|Oral Cancer News|

Positron Emission Tomography Offers Modest Improvement for Staging of Head and Neck Cancers: Presented at AHNS

Source: Doctor's Guide (www.docguide.com) Author: Arushi Sinha Use of positron emission tomography (PET) imaging offers modest improvement in positive predictive value, specificity, and accuracy compared with computed tomography (CT) for diagnosing head and neck cancers. Researchers at the American Head and Neck Society 7th International Conference on Head and Neck Cancer (AHNS) presented new data on the effectiveness of PET scans singly or in combination with CT compared with CT scans alone. "We used the scans in comparison to the gold standard, which was the pathology findings from neck dissections," explained study presenter Surjeet Pohar, MD, Department of Radiation Oncology, Eastern Virginia Medical School, Norfolk, Virginia. The study, presented in a poster session on July 22, used information gathered from 36 patients diagnosed with head and neck squamous cell carcinoma. All the patients underwent neck dissection as well as CT scans, PET scans, or combined PET and CT. In addition, all patients received a full medical examination, endoscopy, and X-ray imaging to help stage their disease. In addition, nodal involvement and information about the side of the neck were also documented. As a result of the full diagnostic workup, the researchers found that most patients exhibited locally advanced disease: 4 patients had stage II disease; 3 had stage III disease; and 25 had stage IV disease. Four patients had indeterminate staging at the time of the initial workup. Results showed that several parameters of the different imaging technique were comparable. CT scans exhibited sensitivity to the samples in 72% of [...]

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