¹⁸F-labeled fluoro-2-deoxyglucose positron emission tomography-computed tomography for response evaluation in head and neck malignancy

Head and neck squamous cell carcinoma (HNSCC) accounts for 90% of head and neck cancers. There has been no established qualitative system of interpretation for therapy response assessment using positron emission tomography-computed tomography (PET-CT) for HNSCC. The study aims to (i) apply Likert scale (Deauville criteria score (DS)) and/or SUVmax to all follow-up PET scans, (ii) determine whether interpretation of follow up PET scans can be improved, (iii) categorize as responders versus nonresponders. Qualitative criteria using DS has been found to be useful in response evaluation of nodal status in HNSCC patients. High NPV (DS 1–3) and PPV (DS 4–5) of follow-up PET-CT in HNSCC is beneficial in restaging of disease and decision-making regarding neck dissection. All patients with a post-RT PET-CT scan DS 4/5 are at great risk of disease progression as they harbor active tumor in the nodes and neck dissection should be considered. Consensus regarding qualitative assessment in future can facilitate PET reporting in clinical practice