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PET Imaging May Not Improve Diagnostic Accuracy in Early Head and Neck Cancer NEW YORK -- May 14, 2008 -- Positron emission tomography with a radioactive tracer (18F-FDG PET) may not improve the detection of small metastases in patients with head and neck cancer who have no clinical evidence of disease in neighbouring lymph nodes, suggest results published in the May 13 issue of the Journal of the National Cancer Institute. To systematically examine the value of FDG PET for diagnosing clinically node-negative patients, John P.A. Ioannidis, MD, University of Ioannina School of Medicine, Ioannina, Greece, and colleagues performed a meta-analysis of 32 previously published studies that tested FDG PET in patients with head and neck cancer with 1 or fewer nodal metastases. FDG PET failed to identify 50% of the occult lesions in clinically node-negative patients and incorrectly identified normal tissue as being cancerous 13% of the time. When the researchers compared the sensitivity and specificity of FDG PET with magnetic resonance imaging and commuted tomography, they found that there was a trend for a small improvement in detection with FDG PET, but the differences were not statistically significant. The false-positive rate was similar for all 3 imaging techniques. "Thus, there is little evidence to support the routine use of 18F-FDG PET to evaluate possible lymph node metastasis among patients with [head and neck squamous cell cancer] and a clinically [node-] negative neck," the authors said. SOURCE: Journal of the National Cancer Institute E-mail this page to a friend or colleague! To print, use this version