Click image for full sizePET / CT has a greater sensitivity and specificity for detection of regional metastatic adenopathy for head and neck tumors than contrast enhanced CT. More importantly PET changes the course of management in patients with head and neck Ca in 33% of the cases where it is performed. It is also more sensitive and specific than CT for detection of local recurrence. There may be a role for PET in evaluating response to therapy for head and neck tumors but this is still developing. Remember many areas of normal FDG uptake are found in the head and neck including: Palatine, faucil and retropharyngeal tonsilar tissue, parotid, sub lingual and submandibular glands, strap muscles and the vocal cords.
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