Recurrence Detection by Hybrid [$^{18}$F]FDG-PET in Advanced Head and Neck Squamous Cell Carcinoma

BACKGROUND In the clinical management of advanced stage head and neck squamous cell carcinoma, the use of hybrid [$^{18}$F]FDG-PET imaging is well established. However, there is ongoing debate regarding the optimal frequency of hybrid PET scans to be included in follow-up protocols, particularly if the initial post-therapeutic scan is negative. METHODS We conducted a single-center 10-year retrospective study involving all patients who underwent hybrid PET scans for the follow-up of advanced stage head and neck cancer. A total of 285 patients were included. RESULTS Out of 199 patients with a negative 3-month hybrid PET, 15% subsequently developed a recurrence during further follow-up. Notably, 90% of these recurrences were detected by hybrid PET. CONCLUSION Fifteen percent of patients with a negative 3-month hybrid PET experienced a recurrence. Given that the majority of recurrences were detected by hybrid PET scans, there is a compelling argument for incorporating regular repetitive scans during follow-up.