Background: Comparison of the diagnostic validity of positron emission tomography (PET) alone with integrated PET and CT (PET/CT) in the search for occult primary tumors in patients with cancer of unknown primary (CUP) site in the head and neck.
Methods: Thirty-nine consecutive patients with clinical CUP were investigated with PET and 38 patients with PET/CT. After initial diagnostic panendoscopy and histological confirmation of the cervical lymph node metastasis, either PET or PET/CT scanning was performed.
Results: Integrated PET/CT had a significantly higher overall detection rate than dedicated PET alone (55.2% vs 30.8%; p = .039) and positive prediction rate (93.3% vs 46.1%; p = .01).
Conclusion: Integrated PET/CT showed to be superior to PET in the detection of the primary site of clinically occult tumors in CUP syndrome. However, a negative result should still be investigated further by means of panendoscopy with tonsillectomy and blind biopsies.
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