18F-FDG PET/CT for locoregional surveillance following definitive treatment of head and neck cancer: A meta-analysis of reported studies

Purpose To evaluate the performance of F-18-fluorodeoxy-d-glucose positron emission tomography-computed tomography (F-18-FDG PET/CT) in identifying local failure and regional failure following curative radiotherapy or surgery for head and neck squamous cell carcinoma. Methods A comprehensive literature search identified studies published between January 2010 and August 2016. Diagnostic performance of F-18-FDG PET/CT was evaluated for local failure/regional failure stratified by treatment-to-scan time interval of <= 3 versus >3 months. Results Twenty-four studies (2627 patients) were included. Compared to <= 3 months, F-18-FDG PET/CT performed >3 months showed significantly improved sensitivity (87% vs 60%, P = 0.020) and specificity (93% vs 84%, P < 0.001) for local failure. There was no significant difference in sensitivity (79% vs 56%, P = 0.100) or specificity (95% vs 97%, P = 0.35) for regional failure >3 versus <= 3 months. Conclusions This meta-analysis confirms high specificity but modest sensitivity of posttreatment F-18-FDG PET/CT for local failure and regional failure. Sensitivity and specificity are significantly improved when F-18-FDG PET/CT is performed >3 months for local failure.