The incidence of avid lesions in head and neck cancer patients undergoing positron emission tomography-computed tomography scanning.

OBJECTIVES

This study aimed to determine the incidence, location and outcome of incidental avid lesions on positron emission tomography-computed tomography scans for head and neck cancer.

METHODS

A retrospective study reviewing digital case notes, performed from a single centre. Clinicopathological information was collected and incidental avid lesions on positron emission tomography-computed tomography reports were recorded. Further investigations were followed up to determine the outcome of the lesions.

RESULTS

A total of 281 patients undergoing staging positron emission tomography-computed tomography (stages T4, N3 or unknown primary) and/or treatment response positron emission tomography-computed tomography scans for head and neck cancer were identified, with 363 incidental avid lesions reported in 369 scans. The most common location was the abdomen (30.0 per cent), followed by thorax (28.9 per cent). A total of 33.1 per cent of lesions had further investigation. The rate of incidental synchronous primary was 3.6 per cent.

CONCLUSION

The benefit of investigating carefully selected incidental avid lesions outweighs the harm of investigation, as it may alter management. There is a need for a standardised pathway for investigating these lesions in head and neck cancer services.