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September 7, 2007 - Positron emission tomography-computed tomography using fluorodeoxy-glucose F-18 (FDG-PET/CT) provides early, accurate detection of bone metastases from head and neck squamous cell carcinoma, researchers report in the August issue of Archives of Otolaryngology, Head and Neck Surgery.

Dr. Brian Nussenbaum of Washington University School of Medicine, St. Louis, and colleagues evaluated 13 head and neck squamous cell carcinoma patients with FDG-PET/CT findings suggestive of metastases.

These patients were identified by retrospective review of data from 683 patients with head and neck squamous cell carcinoma who had undergone the procedure during initial staging or restaging.

All of the 13 patients lacked clinical symptoms of bone involvement and nine had serum alkaline phosphatase levels in the normal or minimally elevated range.

Five patients underwent bone biopsy and four were confirmed as having metastasis. The fifth patient was found to have Rosai-Dorfman bone disease, a rare nonmalignant condition, and was excluded from further analysis.

In the remaining 12 patients, FDG-PET/CT identified a total of 27 bone lesions. At the time of metastasis identification, six of the patients had no other identifiable distant metastatic disease and two of these lacked disease at any other site. The findings influenced therapeutic decision making in five patients.

The study "further shows the utility of obtaining PET/CT imaging for radiographically restaging patients with head and neck carcinoma," Dr. Nussenbaum commented to attendees.