Postoperative restaging: PET/CT impact on diagnosis and management

PurposeThe goal of this study was to assess the value of combined PET/CT in the restaging of suspected recurrent cancer and its impact on further management planning of the patients.Patients and methodsFourty-two patients with suspected recurrence due to new clinical, biochemical and radiologic findings were prospectively evaluated. PET/CT results were compared with PET and CT data. A final diagnosis of recurrence was confirmed by biopsy or by further clinical and radiologic work-up.ResultsThirty nine out of 42 patients had recurrence and or distant metastases in 108 malignant sites. For the site-based analysis PET/CT showed 100% sensitivity, 80% specificity, 98% PPV, 100% NPV and 98% accuracy compared with 100%, 50%, 94%, 100% and 95%, respectively, for PET, and 87%, 50%, 94%, 28% and 83%, respectively, for CT. For the patient-based analysis, PET/CT showed 100% sensitivity, 75% specificity, 97% PPV, 100% NPV and 98% accuracy compared with 100%, 50%, 92%, 100% and 93%, respectively for PET and 86%, 75%, 97%, 38% and 86%, respectively for CT. PET/CT results changed the management of 90% of patients.ConclusionPET/CT provides accurate restaging of suspected recurrent cancer with a significant clinical impact on further management planning.