Comparison of PET-CT, CT and MRI scan in initial staging and management of head and neck cancers

Background To evaluate the utility of positron-emission tomography (FDG PET) in initial staging and management of head and neck cancers. Methods This is a retrospective study of 99 treatment naive head and neck cancer patients treated between January 2017 and December 2020 at a tertiary teaching centre. Change in initial staging and management was noted based on PET scan compared to cross-sectional imaging (CT and MRI). Results There were 73 (73.7%) males and 26 (26.2%) females with male-to-female ratio of 2.8:1.Overall, change in management was seen in 36/99 (36.4%) patients due to PET scan. With regards to initial staging, T, N and M stage was changed in 14/99 (14.1%), 19/99 (19.1%) and 3/99 (3%) patients, respectively. These changes were significantly higher in patients with unknown primary (63.3%, p value -0.001) and N3 (41%, p -0.045) nodal disease. Conclusion PET-CT plays an important role in appropriate initial staging and subsequent treatment planning of head and neck cancers. Advances in knowledge Initial staging PETCT changes management in 36.4% cases. Accuracy of various different imaging modalities have been compared.

Automated summary

This retrospective study evaluated the utility of FDG PET in initial staging and management of head and neck cancers, finding that PET-CT changed management in 36.4% of cases. It concluded that PET-CT plays an important role in appropriate initial staging and subsequent treatment planning.