Staging of Head and Neck Squamous Cell Cancer with Extended-Field FDG-PET

David L. Schwartz, Joseph Rajendran, Bevan Yueh, Marc Coltrera, Yoshimi Anzai, Kenneth Krohn, Janet Eary

Research output: Contribution to journalArticlepeer-review

102 Scopus citations


Background: Accurate baseline staging is necessary to appropriately treat head and neck squamous cell carcinoma. [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) is valuable for locoregional staging of primary head and neck disease. The effectiveness of FDG-PET for the detection of distant metastatic or synchronous disease remains unproven. Objective: To investigate the utility of FDG-PET extended into the abdomen (extended-field FDG-PET) for wide-field staging of head and neck tumors. Methods: This is a prospective institutional study of 35 consecutive patients diagnosed with American Joint Committee on Cancer (AJCC)-defined stage II-IV squamous cell carcinoma of the oral cavity, oropharynx, or larynx between September 2000 and June 2002. Thirty-three patients (94%) were eligible for analysis. All patients were routinely staged with chest radiography, liver function tests, and extended-field FDG-PET. Chest or abdominal computed tomographic scans were used as corroborative studies and were obtained only when one of the above tests indicated distant disease. Results: Of 33 patients, 7 (21%) had evidence of distant disease by extend-field FDG-PET-4 with metastases and 3 with synchronous primary cancers of the aerodigestive tract. [F-18]-fluorodeoxyglucose PET detected hepatic, bone, gastrointestinal, and mediastinal disease not identified by chest radiography or liver function tests. Two of the 7 patients with FDG-avid distant disease had false-negative staging by all other tests, including computed tomography. Conclusions: Extended-field FDG-PET is feasible and may improve staging of primary head and neck squamous cell carcinoma. Use of staging FDG-PET must be explicitly described in reports from centers engaged in prospective research to facilitate comparison with historical results.

Original languageEnglish (US)
Pages (from-to)1173-1178
Number of pages6
JournalArchives of Otolaryngology - Head and Neck Surgery
Issue number11
StatePublished - Nov 2003


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