Should We Routinely Investigate Incidental Head and Neck Findings on 18-Fluorodeoxyglucose Positron Emission Tomography in Patients Being Staged for Non-small Cell Lung Cancer? A Retrospective Analysis

Akshay Patel; Troy Perry; Ian Hunt; Jonathan Abele; Connor Maquire; Michael Allegretto; Eric Bedard

doi:10.1055/s-0034-1381742

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2015; 63(07): 604-608
DOI: 10.1055/s-0034-1381742

Original Thoracic

Georg Thieme Verlag KG Stuttgart · New York

Should We Routinely Investigate Incidental Head and Neck Findings on 18-Fluorodeoxyglucose Positron Emission Tomography in Patients Being Staged for Non-small Cell Lung Cancer? A Retrospective Analysis

Akshay Patel

¹Division of Thoracic Surgery, St George's Hospital, London, England, United Kingdom

,

Troy Perry

²Department of Thoracic Surgery, University of Alberta, Edmonton, Alberta, Canada

,

Ian Hunt

¹Division of Thoracic Surgery, St George's Hospital, London, England, United Kingdom

,

Jonathan Abele

³Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada

,

Connor Maquire

³Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada

,

Michael Allegretto

⁴Division of Otolaryngology, University of Alberta, Edmonton, Alberta, Canada

,

Eric Bedard

²Department of Thoracic Surgery, University of Alberta, Edmonton, Alberta, Canada

› Author Affiliations

Abstract

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Abstract

Background Positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) is routinely performed for investigating suspected lung cancers. Despite the known potential for false-positive FDG uptake in the head and neck, most suspicious lesions on FDG-PET are investigated.

Methods Between October 2002 and January 2010, FDG-PET/PET-computed tomography (CT) reports showing significant incidental uptake were retrospectively analyzed using controls to compare time to treatment for lung cancer and the rate of secondary malignancy in those with and without incidental head and neck FDG uptake.

Results In this study, 48/1,846 PET/PET-CT scan reports reviewed, and demonstrated nonthyroidal head and neck abnormalities. A total of 30 patients had proven non-small cell lung cancer (1.6%); 3/30 (10%) went on to have biopsy proven malignancy. Furthermore, there was a significant increase in time to treatment in those patients with incidental head and neck findings (p = 0.002).

Conclusion These unexpected findings are mostly of no clinical significance and the patient should continue treatment without delay; however, aggressive work-up should be pursued if concerns for head and neck pathology are raised following clinical assessment.

Keywords

18-fluorodeoxyglucose - positron emission tomography - non-small cell lung cancer

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References

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