Importance of PET/CT in Initial Workup of Head and Neck Squamous Cell Carcinoma

Abstract

Abstract Objective Assess the impact of positron emission tomography/computed tomography (PET/CT) on disease staging at presentation in patients with head and neck squamous cell carcinoma. Study Design Retrospective cross‐sectional review. Setting Academic multicenter single institution (Geisinger Health System). Methods All patients who had PET/CT imaging during workup for head and neck squamous cell carcinoma were included in the study. Pre‐ and post‐PET/CT clinical staging were recorded. Statistical analyses were performed for patients with a change in clinical staging or detection of second primary malignancies on PET/CT. Results A total of 292 patients were included in the study, 238 of whom underwent PET/CT imaging as part of their initial workup. Twenty‐eight (11.9%) patients were clinically upstaged on PET/CT with 7 patients having treatment alterations based on imaging. Eighteen (7.6%) patients were found to have second primary malignancies on PET/CT. Conclusion The current study further illustrates the importance of PET/CT in the workup of head and neck squamous cell carcinoma. Without the inclusion of PET/CT imaging, 19.3% of patients would have either been staged inappropriately or had second primary malignancies missed, again confirming the necessity of comprehensive functional imaging during the initial pretreatment workup.

Keywords

• head and neck squamous cell carcinoma
• PET/CT
• second primary malignancies
• staging