2017 Section 7 Green Book

Otolaryngology–Head and Neck Surgery 154(3)

Figure 7. Forest plots of sensitivity and specificity for positron emission tomography and positron emission tomography/computed tomo- graphy in the diagnosis of residual and/or recurrent disease at multiple sites combined.

Table 2. Summary Estimates of Sensitivity and Specificity and the Results of Subgroup Analysis for Imaging Modality, Image Analysis, and Timing of Scan

Local Residual/Recurrent Disease

Nodal Residual/Recurrent Disease

Subgroup

Sensitivity, % (95% CI)

Specificity, % (95% CI)

Sensitivity, % (95% CI)

Specificity, % (95% CI)

Imaging modality PET

76.5 (72.0-80.6) a 89.8 (85.8-92.9) a

72.0 (60.4-81.8) 73.0 (55.9-86.2)

87.7 (83.9-90.8) 89.4 (84.5-93.2)

90.7 (82.5-95.9) 80.8 (69.9-89.1)

PET/CT

Image analysis Visual

86.7 (78.4-92.7) 85.2 (73.8-93.0)

80.2 (75.5-84.4) 84.2 (80.1-87.8)

63.9 (50.6-75.8) 81.8 (64.5-93.0)

88.4 (83.4-92.4) 88.6 (84.3-92.0)

Semiquantitative

Timing of scan \ 12 wk

79.9 (76.1-83.4) b 88.4 (83.0-92.6) b

86.2 (82.6-89.3) c 96.0 (90.1-98.9) c

84.8 (75.0-91.9) 87.5 (77.6-94.1)

67.5 (56.1-77.6) 82.6 (61.2-95.0)

. 12 wk

Abbreviations: CI, confidence interval; CT, computed tomography; PET, positron emission tomography. a Statistically significant difference ( P \ .001). b Statistically significant difference ( P = .009). c Statistically significant difference ( P = .004).

In our systematic review and meta-analysis, we included only prospective studies that used dedicated PET or PET/ CT scans for the detection of residual/recurrent disease in

patients with SCCs of the head and neck. Our review included 27 prospective studies, comprising 1195 patients, published between 1993 and 2014. There were 6 studies

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