There is quite a bit of recent literature comparing PET scans (alone) to PET/CT scans etc. which seems to show a significant improvement in detection from the newer technology. However, who reads the scan is also important, how many HNC scans have they seen? Someone who sees a lot of these is probably going to have more ability to pick out a cancer signal from healing or inflammation.

There is also a rather strict protocol to be followed before the test. Fasting for 4-12 hours (seems to depend on area to be scanned, Barry was told to fast for at least 5 hours), to avoid foods containing sugar or simple carbs from the day before, no caffeine, only water . The goal of this is to reduce available blood sugar so that the cells compete for the labelled glucose. Blood sugar is tested before the label is given, and needs to be in a certain range. Also, strict inactvity in a dim room for 45 minutes before the test (no reading, talking etc.) so that the muscles do not also compete for the label. Barry had a head/neck scan and then, a whole-body scan (arms in different positions).

The surgeon we consult with (not our ENT) emphasized that he had reasonable confidence in a properly admistered PET/CT combined scan, read by someone who knew what they were doing. He would not want to decide on whether to do post-treatment surgery or not based just on a PET scan. He has had experience with (PET) false positives, when he did surgery and no cancer was found. Thus now he would want to re-scan in a month or perhaps add an MRI if there were suspicious areas. He emphasized that PET/CT was just one tool that is used to determine status, although an important one.

Gail