Use of PET/CT to detect local and regional laryngeal cancer recurrence after surgery

Abstract

Background: Laryngeal cancer is the second most common cancer of the head and neck after cancer of the oral cavity. The primary causes of death in cases of laryngeal cancer are the recurrence of locoregional disease and distant metastasis. Anatomic and tissue alterations resulting from surgery and/or radiotherapy of primary laryngeal tumors can make it difficult to determine a locoregional recurrence or residual disease by physical examination or computed tomography (CT)/magnetic resonance imaging (MRI). The majority of studies have shown a high accuracy in the detection of local and regional recurrence of head and neck cancer after different treatment modalities, using fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT. Aim: To determine the diagnostic accuracy of PET/CT in patients with suspicion of locoregional recurrence from laryngeal carcinoma after surgery with or without adjuvant radiotherapy. Materials and methods: This was a retrospective study. Forty-five patients who previously underwent surgical treatment with or without adjuvant radiotherapy for primary laryngeal squamous cell carcinoma and who underwent examination using FDG-PET/CT imaging after clinical and instrumental (CT/MRI) suspicion of locoregional recurrence (T or N) were recruited. Results: Overall specificity, sensitivity, and accuracy of PET/CT were found to be 88%, 100%, and 93.3%, respectively. With respect to the suspected cases of recurrence in the primary site, sensitivity, specificity, and accuracy of PET/CT were found to be 100%, 87.5%, and 91.6%, respectively. In patients with suspected metastatic neck disease, PET/CT revealed a sensitivity, specificity, and accuracy of 100%, 90%, and 95.4%, respectively. Conclusion: According to the results of this study, PET/CT imaging in laryngeal tumors is a useful tool in case of suspected locoregional recurrence where conventional imaging (CT and MRI) is unable to resolve the diagnostic doubt.