Objective: To determine whether combined positron emission tomography and computed tomography (PET/CT) could help to avoid unnecessary planned neck dissections in patients with advanced head and neck squamous cell carcinoma (HNSCC), we designed an observational study of patients with de novo cervical N2-N3 regional spread of HNSCC.
Design: We included all patients who underwent posttreatment PET/CT within 5 months of completing chemoradiation therapy. Thirty such patients were identified. The PET/CT was “positive” if the radiologist recommended tissue sampling or resection of cervical lymph nodes. Patients who had positive PET/CT underwent confirmatory biopsy given clinical suspicion for recurrent disease. Patients with “negative” PET/CT were followed clinically and radiographically for a minimum of 9 months (median, 20 months).