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. 2023 Jan;45(1):207-211.
doi: 10.1002/hed.27227. Epub 2022 Oct 27.

Diagnostic efficacy of positron emission computerized tomography scans in suspicious laryngeal findings postorgan preservation treatment

Anton Warshavsky  1 , Ariel Holan  1 , Nidal Muhanna  1 , Yael Oestraicher  1 , Yuval Nachalon  1 , Liyona Kampel  1 , Narin Nard-Carmel  1 , Hen Chaushu  1 , Udi Shapira  1 , Omer Ungar  1 , Orit Gutfeld  2 , Inna Ospovat  2 , Yasmin Natan Oz  2 , Einat Even-Sapir  3 , Gilad Horowitz  1
Affiliations

Diagnostic efficacy of positron emission computerized tomography scans in suspicious laryngeal findings postorgan preservation treatment

Anton Warshavsky et al. Head Neck. 2023 Jan.

Abstract

Background: Larynx preservation protocols (LPP) for glottic primary squamous cell carcinoma has gained popularity worldwide. Direct laryngoscopy (DL) with biopsy is mandated when recurrence is suspected. The efficacy of 18Fluoro-deoxy-glucose positron emission computerized tomography (PET-CT) as alternative first-line diagnostic investigation in suspected recurrence was evaluated.

Methods: A retrospective study of patients with suspicious fiber-optic findings at more than 12 weeks after LPP. Sensitivity, specificity, and the negative predictive value (NPV) of DL and PET-CT were compared.

Results: Seventy-two patients presenting 105 cases of suspicious events were included in this study. Fifty-two events were initially investigated by DL and 53 events by PET-CT. The sensitivity of DL and PET-CT was 56.25% and 100%, respectively. The NPV was 84% for DL and 100% for PET-CT (p = 0.015).

Conclusion: Negative PET scans after LPP are highly accurate in ruling out recurrent/persistent disease and may spare the patient from negative biopsies.

Keywords: direct laryngoscopy; follow-up; larynx; positron emission tomography scan.

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