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Year :2022
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Month :
January-February
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Volume :
11
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Issue :
1
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Page :
RO34 - RO38
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Accuracy of Computed Tomography Pretreatment Staging and Post-treatment Recurrence in Head and Neck Cancers in Rural Western India- A Retrospective Observational Study
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Correspondence Address :
Radhika Himanshu Pandya, Parth Joshi, Rushikumar D Panchal, Viral Patel,
Dr. Radhika Himanshu Pandya,
Assistant Professor, Department of Radiodiagnosis, Shree Krishna Hospital and
Pramukhswami Medical College, Karamsad, Anand-388325, Gujarat, India.
E-mail: itsradhs@gmail.com
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Introduction: Introduction: Cancers of head and neck are the most common in developing countries especially, in India. Multi-disciplinary approach and treatment are required in management of head and neck cancers which include surgeries, radiotherapy techniques and chemotherapy regimens. These can complicate the post-treatment imaging field and contribute to difficulties in image interpretation. Knowledge of these expected post-treatment changes, possible complications and the capability to identify early changes of tumour recurrence is an integral part of post-treatment surveillance and effective management.
Aim: To evaluate the effectiveness of Multi-Detector Computed Tomography (MDCT) in pretreatment staging, post-treatment response and recurrence in comparison with Positron Emission-Computed Tomography (PET-CT).
Materials and Methods: A retrospective observational study was conducted including 101 patients, undergoing pre- and post-treatment, contrast enhanced CT scan with sections from skull base to base of neck. The pretreatment imaging of primary tumour was assessed for its Tumour (T) and Node (N) stage with corresponding staging on histopathology. The imaging observations on pre- and post-treatment scans, for outcomes on recurrence, residual disease and cure were considered. Recurrence when suspected on post-treatment CT scan was confirmed with PET-CT or biopsy. The agreement of T and N staging on pretreatment CT scan with that on histopathology was examined using quadratic weighted kappa. Sensitivity and specificity for detection of post-treatment recurrence on CT scan was determined by measuring true positive rates and true negative rates.
Results: An agreement of 0.4 and 0.58 (kappa coefficient) was found between T and N staging on CT and histopathology which suggests fair accuracy of CT in pretreatment staging of head and neck cancers. The CT had a sensitivity and specificity of 88.89% and 100% for detecting recurrence in head and neck cancers in post-treatment neck CT scan in the background of post-treatment imaging changes.
Conclusion: The MDCT is a good imaging tool in pretreatment staging of head and neck cancers. It effectively detects recurrence in the background of post-treatment changes. A standard post-treatment evaluation protocol should be followed.
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