Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2003-4-11
pubmed:abstractText
The purpose of this study was to calculate disease probabilities based on data of patients with head and neck cancer in the register of our institution and to perform a systematic review of the available data on the accuracy of PET in the primary assessment and follow-up of patients with head and neck cancer. The pre-test probability of head and neck cancer among patients in our institutional data registry was assessed. Then the published literature was selected and appraised according to a standard protocol of systematic reviews. Two reviewers independently selected and extracted data on study characteristics, quality and accuracy. Accuracy data were used to form 2 x 2 contingency tables and were pooled to produce summary receiver operating characteristic (ROC) curves and summary likelihood ratios for positive and negative testing. Finally post-test probabilities were calculated on the basis of the pre-test probabilities of this patient group. All patients had cytologically or histologically proven cancer. The prevalence of additional lymph node metastases on PET in staging examinations was 19.6% (11/56), and that of locoregional recurrence on restaging PET was 28.6% (12/42). In the primary assessment of patients, PET had positive and negative likelihood ratios of 3.9 (2.56-5.93) and 0.24 (0.14-0.41), respectively. Disease probabilities were therefore 49.4% for a positive test result and 5.7% for a negative test result. In the assessment of recurrence these values were 3.96 (2.8-5.6) and 0.16 (0.1-0.25), resulting in probabilities of 49.7% and 3.8%. PET evaluation for involvement of lymph nodes had positive and negative likelihood ratios of 17.26 (10.9-27.3) and 0.19 (0.13-0.27) for primary assessment and 11.0 (2.93-41.24) and 0.14 (0.01-1.88) for detection of recurrence. The probabilities were 81.2% and 4.5% for primary assessment and 73.3% and 3.4% for assessment of recurrence. It is concluded that in this clinical setting the main advantage of PET is the ability to reliably rule out the presence of disease in both staging and restaging. Further research is required to derive probabilities for individual patients from sequential testing as applied in the diagnostic work-up of patients with head and neck cancer.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
1619-7070
pubmed:author
pubmed:issnType
Print
pubmed:volume
30
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
562-71
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:12589477-Adult, pubmed-meshheading:12589477-Aged, pubmed-meshheading:12589477-Aged, 80 and over, pubmed-meshheading:12589477-Female, pubmed-meshheading:12589477-Fluorodeoxyglucose F18, pubmed-meshheading:12589477-Head and Neck Neoplasms, pubmed-meshheading:12589477-Humans, pubmed-meshheading:12589477-Lymphatic Metastasis, pubmed-meshheading:12589477-Male, pubmed-meshheading:12589477-Middle Aged, pubmed-meshheading:12589477-Models, Biological, pubmed-meshheading:12589477-Models, Statistical, pubmed-meshheading:12589477-Neoplasm Recurrence, Local, pubmed-meshheading:12589477-Prevalence, pubmed-meshheading:12589477-Radiopharmaceuticals, pubmed-meshheading:12589477-Reproducibility of Results, pubmed-meshheading:12589477-Risk Assessment, pubmed-meshheading:12589477-Sensitivity and Specificity, pubmed-meshheading:12589477-Switzerland, pubmed-meshheading:12589477-Tomography, Emission-Computed
pubmed:year
2003
pubmed:articleTitle
Assessment of clinical utility of 18F-FDG PET in patients with head and neck cancer: a probability analysis.
pubmed:affiliation
Division of Nuclear Medicine, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. gerhard.goerres@dmr.usz.ch
pubmed:publicationType
Journal Article