Abstract
The strengths and potential pitfalls of fluorodeoxyglucose positron emission tomographic (FDG-PET) imaging in patients with head and neck cancer, especially those who have undergone surgery and/or chemotherapy and irradiation, is reviewed. PET is performed using the radiopharmaceutical [18F]-FDG, a D-glucose analog. The increased vascularity of tumors and glucose metabolism by malignant cells result in preferential uptake of FDG by tumor cells. The inability to process metabolites of the modified glucose molecule causes intracellular accumulation of 18F-containing radioisotopes. This metabolism has been invaluable in the evaluation of many cancer patients, and PET plays a pivotal role in the diagnosis, staging, and restaging of head and neck oncology patients. The ability to assess the functional status of tissue with FDG-PET has been remarkable and addresses this well-known limitation of conventional cross-sectional computed tomographic (CT) and magnetic resonance (MR) imaging.
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References
Nahmias C, Carlson ER, Duncan LD et al (2007) Positron emission tomography/computerized tomography (PET/CT) scanning for preoperative staging of patients with oral/head and neck cancer. J Oral Maxillofac Surg 65:2524–2535
van den Brekel MW, Stel HV, Castelijns JA et al (1990) Cervical lymph node metastasis: assessment of radiologic criteria. Radiology 177:379–384
Cerezo L, Millan I, Torre A et al (1992) Prognostic factors for survival and tumor control in cervical lymph node metastases from head and neck cancer. A multivariate study of 492 cases. Cancer 69:1224–1234
Schuller DE, McGuirt WF, McCabe BF, Young D (1980) The prognostic significance of metastatic cervical lymph nodes. Laryngoscope 90:557–570
Snow GB, Annyas AA, van Slooten EA et al (1982) Prognostic factors of neck node metastasis. Clin Otolaryngol Allied Sci 7:185–192
Fleming AJ Jr, Smith SP Jr, Paul CM et al (2007) Impact of [18F]-2-fluorodeoxyglucose-positron emission tomography/ 242 L.A. Loevner computed tomography on previously untreated head and neck cancer patients. Laryngoscope 117:1173–1179
Zanation AM, Sutton DK, Couch ME et al (2005) Use, accuracy, and implications for patient management of [18F]-2-fluorodeoxyglucose-positron emission/computerized tomography for head and neck tumors. Laryngoscope 115:1186–1190
Schoder H, Yeung HW, Gonen M et al (2004) Head and neck cancer: clinical usefulness and accuracy of PET/CT image fusion. Radiology 231:65–72
de Bondt RB, Nelemans PJ, Hofman PA et al (2007) Detection of lymph node metastases in head and neck cancer: a metaanalysis comparing US, USgFNAC, CT and MR imaging. Eur J Radiol 64:266–272
Yamazaki Y, Saitoh M, Notani K et al (2008) Assessment of cervical lymph node metastases using FDG-PET in patients with head and neck cancer. Ann Nucl Med 22:177–184
Hannah A, Scott AM, Tochon-Danguy H et al (2002) Evaluation of 18 F-fluorodeoxyglucose positron emission tomography and computed tomography with histopathologic correlation in the initial staging of head and neck cancer. Ann Surg 236:208–217
Teknos TN, Rosenthal EL, Lee D et al (2001) Positron emission tomography in the evaluation of stage III and IV head and neck cancer. Head Neck 23:1056–1060
Hafidh MA, Lacy PD, Hughes JP et al (2006) Evaluation of the impact of addition of PET to CT and MR scanning in the staging of patients with head and neck carcinomas. Eur Arch Otorhinolaryngol 263:853–859
Nakamoto Y, Cohade C, Tatsumi M et al (2005) CT appearance of bone metastases detected with FDG PET as part of the same PET/CT examination. Radiology 237:627–634
Lell M, Baum U, Greess H et al (2000) Head and neck tumors: imaging recurrent tumor and post-therapeutic changes with CT and MRI. Eur J Radiol 33:239–247
Fukui MB, Blodgett TM, Snyderman CH et al (2005) Combined PET-CT in the head and neck: part 2. Diagnostic uses and pitfalls of oncologic imaging. Radiographics 25:913–930
Blodgett TM, Fukui MB, Snyderman CH et al (2005) Combined PET-CT in the head and neck: part 1. Physiologic, altered physiologic, and artifactual FDG uptake. Radiographics 25:897–912
Goerres GW, von Schulthess GK, Hany TF (2002) Positron emission tomography and PET CT of the head and neck: FDG uptake in normal anatomy, in benign lesions, and in changes resulting from treatment. AJR Am J Roentgenol 179:1337–1343
Shreve PD, Anzai Y, Wahl RL (1999) Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics 19:61–77
de Groot M, Meeuwis AP, Kok PJ et al (2005) Influence of blood glucose level, age and fasting period on non-pathological FDG uptake in heart and gut. Eur J Nucl Med Mol Imaging 32:98–101
Israel O, Weiler-Sagie M, Rispler S et al (2007) PET/CT quantitation of the effect of patient-related factors on cardiac 18FFDG uptake. J Nucl Med 48:234–239
Davis E, Solis V, Rosenberg RJ, Spencer RP (2004) Asymmetric tongue muscle uptake of F-18 FDG: possible marker for cranial nerve XII paralysis. Clin Nucl Med 29:531–533
Wong WL, Gibson D, Sanghera B et al (2007) Evaluation of normal FDG uptake in palatine tonsil and its potential value for detecting occult head and neck cancers: a PET CT study. Nucl Med Commun 28:675–680
Nakamoto Y, Tatsumi M, Hammoud D et al (2005) Normal FDG distribution patterns in the head and neck: PET/CT evaluation. Radiology 234:879–885
Chen YK, Su CT, Chi KH et al (2007) Utility of 18F-FDG PET/CT uptake patterns in Waldeyer’s ring for differentiating benign from malignant lesions in lateral pharyngeal recess of nasopharynx. J Nucl Med 48:8–14
Shipchandler TZ, Lorenz RR (2008) Unilateral submandibular gland aplasia masquerading as cancer nodal metastasis. Am J Otolaryngol 29:432–434
Cohade C, Osman M, Pannu HK, Wahl RL (2003) Uptake in supraclavicular area fat (“USA-Fat”): description on 18F-FDG PET/CT. J Nucl Med 44:170–176
Jacene HA, Goudarzi B, Wahl RL (2008) Scalene muscle uptake: a potential pitfall in head and neck PET/CT. Eur J Nucl Med Mol Imaging 35:89–94
Nedergaard J, Bengtsson T, Cannon B (2007) Unexpected evidence for active brown adipose tissue in adult humans. Am J Physiol Endocrinol Metab 293:E444–E452
Jackson RS, Schlarman TC, Hubble WL, Osman MM (2006) Prevalence and patterns of physiologic muscle uptake detected with whole-body 18F-FDG PET. J Nucl Med Technol 34:29–33
Berger KL, Nicholson SA, Dehdashti F, Siegel BA (2000) FDG PET evaluation of mucinous neoplasms: correlation of FDG uptake with histopathologic features. AJR Am J Roentgenol 174:1005–1008
Ishizumi T, Tateishi U, Watanabe S et al (2007) F-18 FDG PET/CT imaging of low-grade mucoepidermoid carcinoma of the bronchus. Ann Nucl Med 21:299–302
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© 2012 Springer-Verlag Italia
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Loevner, L.A. (2012). Integrated PET-CT and PET-MR: Pitfalls and Applications in Head and Neck Squamous Cell Carcinoma. In: Hodler, J., von Schulthess, G.K., Zollikofer, C.L. (eds) Diseases of the Brain, Head & Neck, Spine 2012–2015. Springer, Milano. https://doi.org/10.1007/978-88-470-2628-5_34
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DOI: https://doi.org/10.1007/978-88-470-2628-5_34
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